Question: The physician documented that he applied a "noninva-sive ventilation method" to help an elderly emphysema patient who had acute respiratory failure. He said he hooked a mask onto a mechanical ventilator in the mobile intensive care unit. How should I report this?
California Subscriber
Answer: In this case, you should report 94656 (Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; first day) for the first day of treatment. For subsequent days, you should assign 94657 (... subsequent days).
The physician's documentation should provide a brief assessment of the patient's current condition, including the initial or current vent settings, any changes to those parameters (for example, titration of peak-end expiratory pressure [PEEP] to keep FiO2 low), and recommendations and/or orders relating to the vent setting changes
Try this: When the physician applies the mask to a continuous positive airway pressure ventilation machine to check for positive airway pressure, you should select 94660 (Continuous positive airway pressure ventilation [CPAP], initiation and management). But if the physician is looking for negative pressure, you should use 94662 (Continuous negative pressure ventilation [CNP], initiation and management).
-- Reader Questions reviewed by Sarah L. Goodman, MBA, CPC-H, CCP, president of SLG Inc. Consulting in Raleigh, N.C.
