Pulmonology Coding Alert

Question: A provider used a bilevel positive airway pressure (BiPAP) device as a ventilator for a patient since our facility ran out of ventilators.

What code should I assign for the BiPAP device?

New Mexico Subscriber

Answer: BiPAP devices are ventilators and can be used to deliver noninvasive ventilation. Healthcare professionals created or repurposed a variety of devices during the COVID-19 pandemic to support the medical needs of their patients. Many patients diagnosed with COVID-19 needed ventilators due to the severity of their condition, which required physicians to fine-tune the devices to ensure safe and proper ventilation.

You’ll assign 94660 (Continuous positive airway pressure ventilation (CPAP), initiation and management) for the BiPAP device. Even though the descriptor for 94660 calls out CPAP, the American Medical Association (AMA) instructs you to use the CPT^® code for BiPAP devices. BiPAP includes CPAP and pressure support ventilation, and since BiPAP “includes CPAP, CPT^® code 94660 may be used for the initiation and subsequent management of BiPAP,” according to the January 1999 issue of CPT^® Assistant.

Remember: Your documentation will need to specify the use of a bilevel device for noninvasive mechanical ventilation, as well as any modifications to the device, and what settings were used.