A patient, who had suffered acute respiratory failure, is admitted to the long term care hospital (LTCH) for ventilator weaning. On day one, the weaning trial was stopped after 12 hours. On day two, the weaning trial was discontinued after 16 hours. The patient tolerated a weaning trial of 18 hours on the third day. By day 4, the patient had several more hours of monitored weaning and was breathing spontaneously on his own. On day 5, the ventilator was turned off and the patient was extubated. According to clinical protocol at our facility, a patient is not “officially” weaned until he has been totally off of the ventilator for 72 hours. After the patient sucessfully completes the weaning trial, he is continually evaluated. Can we count the additional 72 hours as vent time, since evaluation and monitoring is part of the weaning process?
Assign code 96.72, Continuous invasive mechanical ventilation for 96 consecutive hours or more, since the ventilator was turned off on day 5. After the mechanical ventilator is turned off, it is inappropriate to continue to count ventilation hours, even though the patient is continually being evaluated. The additional 72 hours that the patient is evaluated is not included in the ventilation time.