Health Information Management

Q&A. Separate reporting of infusions before and after CPR

APCs Insider, March 13, 2009

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Q. In the February 20 APC Weekly Monitor, the Q&A stated that infusions were included in CPR. Does this apply only to infusions initiated during the CPR, or to any infusions started before or after the CPR began? Does it include certain drugs only and if so, which ones?

A. The NCCI manual instructions state that:

Procedures routinely performed as part of a comprehensive service are included in the comprehensive service and not separately reported. A number of therapeutic and diagnostic cardiovascular procedures (e.g., CPT codes 92950-92998, 93501-93545, 93600-93624, 93640-93652) routinely utilize intravenous or intra-arterial 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…. In unique circumstances, where these services are performed, not as an integral part of the procedure, the appropriate code can be separately reported with modifier -59.

You can separately report infusions and injections that are clearly documented as occurring before the initiation, and after completion, of CPR. It is critical that the documentation reflect the exact time that CPR begins and ends to clearly delineate that the separately reported services are appropriate.

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