Health Information Management

Q/A: Don?t report 94002 in ED

APCs Insider, February 12, 2010

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Q: May we report CPT code 94002 for a patient started on a ventilator in the ED? Must the patient remain on the ventilator a certain amount of time to charge for this service?
A: Coders may not report 94002 (Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day) for services provided in the ED. This CPT code was effective for services reported on or after January 1, 2007, to report initial ventilator management services in a hospital inpatient setting or observation.  
The 2010 CPT Manual states on page 473, “Do not report 94002–94004 in conjunction with evaluation and management services 99201–99499.” This includes all ED E/M codes.
The CPT Manual also specifically states that coders may not assign ventilator management codes with critical care code 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes).  
Editor’s note: This question was answered by the panelists from HCPro’s sister publication, APC Answer Letter.

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