EmailCPAP titration and coding of duration of NIV
Publication Date: June 2020
Implementation Date: 1/07/2020
ICD 10 AM Edition: Eleventh Edition
Query Number: 3573
Can you please clarify, following VICC query #2823 CPAP titration, the advice to assign 11503-16 [1849] Continuous monitoring of pulmonary function for = 6 hours duration.
Can you please confirm, as the patient is also receiving a period of NIV ventilation, following ACS 1006 Ventilatory support, is it correct to also assign a code from 92209-xx?
CPAP titration: 11503-16 and 92209-xx?
There are no exclude notes at either codes
Search Details
VICC 2823
VICC 2364
ACS 1006
Can you please confirm, as the patient is also receiving a period of NIV ventilation, following ACS 1006 Ventilatory support, is it correct to also assign a code from 92209-xx?
CPAP titration: 11503-16 and 92209-xx?
There are no exclude notes at either codes
Search Details
VICC 2823
VICC 2364
ACS 1006
Response
VICC confirms that it is correct to assign a code for CPAP titration and a code for CPAP when CPAP levels are being titrated.
Therefore, for documentation of CPAP titration or monitoring of CPAP for >= 6 hours, assign:
11503-16 [1849] Continuous monitoring of pulmonary function for >= 6 hours duration, and
an appropriate code from block [570] Noninvasive ventilatory support.
VICC notes that Classification point 1 e. in ACS 1006 Ventilatory Support states, 'Do not code ventilation when the patient brings their own ventilatory support devices (eg CPAP machine) into hospital AND the patient operates the device'.
VICC also notes that when these are the only interventions performed, the episode may not meet criteria for reporting to the VAED because 11503-16 [1849] Continuous monitoring of pulmonary function for >= 6 hours duration and 92209-00 [570] Management of noninvasive ventilatory support, <= 24 hours are on the Not Automatically Qualified for Admission List (NAQAL). Refer to the VAED Criteria for reporting document on the HDSS website for further information.
Therefore, for documentation of CPAP titration or monitoring of CPAP for >= 6 hours, assign:
11503-16 [1849] Continuous monitoring of pulmonary function for >= 6 hours duration, and
an appropriate code from block [570] Noninvasive ventilatory support.
VICC notes that Classification point 1 e. in ACS 1006 Ventilatory Support states, 'Do not code ventilation when the patient brings their own ventilatory support devices (eg CPAP machine) into hospital AND the patient operates the device'.
VICC also notes that when these are the only interventions performed, the episode may not meet criteria for reporting to the VAED because 11503-16 [1849] Continuous monitoring of pulmonary function for >= 6 hours duration and 92209-00 [570] Management of noninvasive ventilatory support, <= 24 hours are on the Not Automatically Qualified for Admission List (NAQAL). Refer to the VAED Criteria for reporting document on the HDSS website for further information.
