Pulmonology Coding Alert

If you're wondering if you have covered all your diagnosis possibilities when coding a patient's ventilation management services (94002-94005), here's a quick refresher.

According to "Prolonged Mechanical Ventilation: Review of Care Settings and an Update on Professional Reimbursement," in the February 2008 edition of CHEST (Vol. 133, No. 2), common diagnoses for patients who require prolonged mechanical ventilation in an acute or long-term care setting include:

• 518.81-518.84 -- Respiratory failure/insufficiency

• 492.8 -- Other emphysema

• 491.21 -- Obstructive chronic bronchitis with [acute] exacerbation

• 482.x-- Pneumonia

• 515 -- Postinflammatory pulmonary fibrosis

• 415.19 -- Other pulmonary embolism and infarction

• V44.0 -- Presence of a tracheostomy

• 428.0 -- Congestive heart failure, unspecified

• 162.5 -- Malignant neoplasm of lower lobe, bronchus or lung

• 340 -- Multiple sclerosis.

Patients on prolonged mechanical ventilation in the home setting typically suffer from one of the following:

• amyotrophic lateral sclerosis (335.20)

• kyphoscoliosis muscular dystrophy (359.1)

• kyphoscoliosis-related respiratory failure (518.83 and 737.30)

• postpoliomyelitis syndrome-related respiratory failure (518.83 and 138), or

• obesity hypoventilation syndrome (518.83 and 278.01).