Pulmonology Coding Alert

Question: How do I code home ventilator management?

Nebraska Subscriber

Answer: You would report 94005 (Home ventilator management care plan oversight of a patient [patient not present] in home, domiciliary or rest home [e.g., assisted living] requiring review of status, review of laboratories and other studies and revision of orders and respiratory care plan [as appropriate], within a calendar month, 30 minutes or more) for each month of 30 minutes or more of home ventilator management care plan oversight (CPO).

• The service includes:
• review of status
• review of laboratories and other studies
• revision of orders and respiratory care plan (as appropriate).

Two important rules guide 94005 coding:

1. You should not bill this code when performed by the same physician/group along with other home (99339-99340) or home health agency, hospice or nursing facility (99374-99378) CPO services, according to the parenthetical instruction following 94005 in the CPT 2007 manual.

2. If another physician concurrently provides CPO during the same period, you may still use 94005.