Pulmonology Coding Alert

Question: I’m new to pulmonology, and I received a critical care report from the physician that lists several services separately. Some of the services include pulse oximetry, chest X-rays, ventilator management, and gastric intubation — does each procedure need to be billed individually?

Michigan Subscriber

Answer: In the CPT^® manual, the introduction for critical care services specifies several services that are bundled into 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes). You should not report these services separately, as they are considered essential to critical care.

The services bundled into 99291 include:

• The interpretation of cardiac output measurements (93561-93562)
• Pulse oximetry (94760-94762)
• Chest X-rays (71045-71046)
• Gastric intubation (43752-43753)
• Temporary transcutaneous pacing (92953)
• Ventilator management (94002-94004, 94660, 94662)
• Vascular access procedures (36000, 36410, 36415, 36591, 36600)
• Blood gases, and information data stored in computers (e.g., ECGs, blood pressures, hematologic data)

Additionally, you will need to report any services that aren’t bundled into critical care services that your physician performs separately.

Note: The CPT^® manual states that facilities can report these services separately.