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MD bills for vent management NPP bills for Critical Care on the same day

Kopp billing Posted Sun 29th of January, 2012 01:13:47 AM

SuperCoder Answered Sun 29th of January, 2012 23:00:42 PM

Daily management of a patient on chronic ventilator therapy does not meet the criteria for critical care unless the critical care is separately identifiable from the chronic long-term management of the ventilator dependence.
So, if the VAP is severe or causes an acute exacerbation of the underlying illness, then documenting and using one of the critical care codes (99291 [Critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 minutes] and possibly +99292 […each additional 30 minutes]) may be most appropriate.
In such a situation, we can bill Critical Care to the NPP with modifier 25.
MD can be billed either with 94002-94003 or subsequent hospital care 99231-99233 as appropriate.

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