# CPR in the ER



## IABrat (Feb 25, 2011)

We have been looking to find out if there are time limits on how long you have to perform CPR in the ER before you can charge for it. We had a patient come in by ambulance at 23:55 in full code he was pronounced at 00:02. Both the nursing staff and the provider are trying to charge for CPR this is quite a large charge and not sure if it is right or not. Haven't seen this situation in our hospital before. Could someone help me out on where to look to find this info. Not having much luck on my own. Also we are a critical access hospital this usually makes charging a little different for us.

Thank you.


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## Andrschery (Feb 28, 2011)

Hi Gabby,

CPR 92950 is not a timed code.  I agree with the nursing staff and provider wanting to charge for the service they provided no matter how long it was performed.  The scenario you provided was that this pt had come in in full arrest so CPR was more than likely being performed in the ambulance as well.  The calling of the code 7 minutes after arrival has nothing to do with the amount of time that CPR was being performed in the ED but the factors prior to arrival i.e. down time, age, past history, DNR status, and prognosis, or outcome.  So, I would bill for the CPR. 

Hope this helps,

Cheryl Anderson, LPN, CEMC, CPC


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## sam_son  (Mar 4, 2011)

I had come accros these cenarios many times.
Procedures like CPR performed means it qualifies for Critical care services.
If the patient was given CPR this patient was suppose to give critical care E/M code. But if the CPR is performed more than 30 mins we will give Critical Care code +CPR code. According to the time CPR was performed CC time will also increases. 

Thanks


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## eadun2000 (Mar 4, 2011)

sam_son  said:


> I had come accros these cenarios many times.
> Procedures like CPR performed means it qualifies for Critical care services.
> If the patient was given CPR this patient was suppose to give critical care E/M code. But if the CPR is performed more than 30 mins we will give Critical Care code +CPR code. According to the time CPR was performed CC time will also increases.
> 
> Thanks



Okay you confused me there.  CC can only be charged if it is equal to or greater than 30 minutes.   Even if they did CPR (which they should charge for in the above situation) that does not equate to an automatic CC because the minutes are not there to support it.


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## FTessaBartels (Mar 4, 2011)

*Cricitcal Care & CPR*

You CANNOT use the time spent in any other billable service/procedure as part of the Critical care time.

So if you are performing CPR for 30 minutes and you are charging for the CPR ... you cannot use that 30 minutes as part of the critical care time.  

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## sam_son  (Mar 7, 2011)

*CPR Vs CC*

CPR is a non-E/M service encompassing such activities as supervising or performing chest compressions, adequate ventilation of the patient (e.g., bag-valve-mask), etc.  CPT does not list a typical time to qualify for providing CPR.  As a separately reportable service with Critical Care, the time spent providing CPR cannot be counted toward calculating total Critical Care time.

Usually when patient is providing CPR and CC togeather, the CPR time can't be separated. because the CPR is the procedure that has to be done from strating to till the end of pronuncing time. they will not stop the CC clock time.

The below path from ACEP explains you clearly how to code CC with CPR.
http://www.acep.org/content.aspx?id=30466

Thanks
Samson B.P.T., M.Sc, C.P.C., CEDC.,


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## kccohen@hotmail.com (Aug 19, 2013)

*CPR with EKG in ER*

if an EKG was done with CPR in the ER, do you 59 the EKG (93005) with CPR (92950)?
thanks


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