Question: Is cardiopulmonary resuscitation (CPR) a separately reimbursable procedure? Do I personally need to perform the compressions to bill for it?
Answer: Current Procedural Terminology (CPT) code 92950 is intended to reimburse for CPR performed to restore and maintain the patient’s respiration and circulation after cessation of heartbeat and breathing. CPR is a separately billable procedure. It can be billed and reimbursed separately from the evaluation and management (E&M) of the patient. According to CPT, to bill for CPR, you need to manage the resuscitation. You do not need to perform the compressions yourself.
Because it is separately billable, you can bill for both the appropriate E&M level emergency department visit (9928x or critical care 99291) in addition to CPR, when appropriate. You should subtract the time spent managing CPR from your critical care time whether or not you successfully achieve return of spontaneous circulation. You may also bill for other separate procedures such as intubation and central line placement, also subtracting their performance time spent from the amount of critical care time claimed. However, defibrillation (different from elective cardioversion) is considered part of CPR and is not separately billable. Correct coding would require modifier -25 for E&M plus procedure and may require modifier -59 for separate procedures. See ACEP’s CPR FAQ for more details.
Brought to you by the ACEP Coding and Nomenclature Committee.
Dr. Friedenson is chair of ACEP’s Coding and Nomenclature Committee and the chief medical officer of Reventics in Denver, Colorado.