tci ED Coding & Reimbursement Alert - 2006 Issue 11

Reader Question: Watch for CPAP/Observation Bundles

Question: A patient with a diagnosis of sleep apnea reported to the ED. In the midst of performing a level-three observation service, the patient suffered acute respiratory failure and the physician stabilized him with continuous positive airway ventilation (CPAP). Can we report two codes -- one for the observation and one for the CPAP?Ohio Subscriber Answer: In this instance, you cannot report the CPAP and the observation. According to the National Correct Coding Initiative (NCCI), CPAP is considered a component of the observation codes, and therefore not separately codable.On the claim,- report 99236 (Observation or inpatient...

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