ED Coding and Reimbursement Alert

Reader Question:

CPR Twice in One Day

Question: One of our ED physicians performed CPR on a 55-year-old patient who came into the facility with symptoms of cardiac arrest. Thirty minutes later, the patient arrested again, and the same physician performed CPR a second time. How should we bill for this?

Michigan Subscriber  
Answer: In this situation, you cannot bill CPR (92950, cardiopulmonary resuscitation [e.g., in cardiac arrest]) twice for the same physician. It might be possible to use modifier -59 (distinct procedural service) appended to the second CPR (92950) to indicate it was performed twice. Individual payer regulations may not allow this, so contact your local payers for directions. 
 
Another possibility is to bill the CPR for the first encounter and then bill critical care (99291, critical care evaluation and management of the critically ill or critically injured patient; first 30-74 minute) for the second encounter, provided the time constraints met the 30-minute criterion for using that CPT code.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

ED Coding and Reimbursement Alert

View All