General Question for the Week of January 8, 2018

General Compliance Question of the Week

Question:

How should we bill Medicare for active cardiopulmonary resuscitation (CPR) given to a patient who arrives at the emergency department (ED) and has a cardiac arrest on arrival? For example, should we bill critical care services or code 92950?

Answer:

You should bill what the documentation supports. Critical care services (99291, 99292) require specific documentation. Although a patient in cardiac arrest would support critical care, the critical care time and the documentation must support those codes. Code 92950 may also be reported with or without critical care.

The bottom line is that it really depends on what the provider was doing. If he or she was actively performing the CPR, then that is the code (along with critical care and/or the ED visit) should be billed. Note that only one provider can bill for critical care. Many times, there are multiple providers in the room; however, the critical care time cannot “overlap” between providers.

 

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.