Intermittent Use of Continuous Positive Airway Pressure (CPAP)
Published on
Wednesday, May 17, 2023
Intermittent Use of Continuous Positive Airway Pressure (CPAP)
Effective date: April 1, 2020
Question:
How do you calculate total hours for a patient that is placed on CPAP intermittently during the daytime, but uses it continuously throughout the night?
Answer:
Code assignment depends on the number of consecutive hours that a patient receives CPAP. The CPAP system is a noninvasive ventilation support system designed only to augment a patient’s breathing, not take over their breathing, as does a ventilator.
Assign code 5A09357 (Assistance with ventilation, less than 24 consecutive hours, continuous positive airway pressure) since the patient received CPAP for less than 24 hours at a time.
Facilities may develop their own internal guidelines, as to whether they code and report CPAP one-time, multiple times or not at all.
Note: Do not assign code Z99.89 (Dependence on other enabling machines and devices) to describe a patient’s CPAP status. ICD-10-CM does not specifically classify CPAP dependence or status.
References:
ICD-10-CM Official Coding Book
Coding Clinic for ICD-10-CM/PCS, First Quarter 2020: Page 10
Article Author: Susie James, RHIT, CCS
Susie James, RHIT, CCS, is the Manager of Inpatient Coding Services at MMP, Inc. Susie has worked in the coding field for over 30 years and has worked as a coder, coding supervisor, and corporate coding manager for a large multi-facility system in Birmingham. She also worked for Alabama Quality Assurance Foundation (AQAF) as a coding reviewer/auditor before joining the team at Medical Management Plus, Inc. Susie has previously served as the President of the Alabama Association of Health Information Management (AAHIM) on the Board of Directors and currently serves as the Education/Coding Roundtable Chair. She is also a member of the American Health Information Management Association (AHIMA) and has previously served as the Co-chair for AHIMA's Leadership Team. She also served as a facilitator at AHIMA's 85th National Convention in Atlanta Georgia.
