Revenue Cycle

Q&A. Charging CPR and injections or infusions with critical care

APCs Insider, February 20, 2009

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Q. Two questions: First, during CPR services, can we charge CPT code 92950 (cardiopulmonary resuscitation [e.g., in cardiac arrest]) in addition to critical care CPT code 99291(critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes)? Second, can we charge for injections/infusions in addition to CPR services?

A. Two great questions: let’s tackle the first. Cardiopulmonary resuscitation, or CPT code 92950, is not included in critical care. Therefore you can report it and charge it separately. Refer to your current CPT manual for further descriptions of what critical care includes and what you thus cannot report separately. It’s important to note that in the OPPS 2009 updates, CMS stated that hospital critical care services should follow the instructions in the CPT manual.

Regarding infusions/injections during the CPR event, according to the past and current Correct Coding Initiative (CCI) Manual, the following instruction states that injections and infusions are included in CPR services. Therefore, do not report or charge them separately:

A number of therapeutic and diagnostic cardiovascular procedures (e.g., CPT codes 92950-92998, 93501-93545, 93600-93624, 93640-93652) routinely utilize intravenous or intraarterial vascular access, routinely require electrocardiographic monitoring, and frequently require agents administered by injection or infusion techniques; accordingly, separate codes for routine access, monitoring, injection or infusion services are not to be reported. [Emphasis added.]

Begin to review your critical care encounters and encounters that involve reporting of CPR (92950) to ensure your claims submission and revenue integrity initiatives comply with the CPT and CCI manual instructions.

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