Trach and ventilation (long)
Patient comes in with previous trach and receives O2 via trach collar. Never attached to the vent, never receives BiPAP or CPAP. Stays longer than 96 hours.
Would you code this as:
96.72, mechanical ventilation > 96 hours, or
93.90, noninvasive mechanical ventilation.
Coding clinics say:
4Q2008: The code title for code 93.90 has been revised to "Noninvasive mechanical ventilation." Mechanical ventilation is classified as noninvasive (93.90) when delivered via a noninvasive interface like a face mask, nasal mask, nasal pillow, oral mouthpiece or oronasal mask, or without an endotracheal tube or tracheostomy. Types of respiratory assistance considered noninvasive mechanical ventilation include continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), noninvasive positive pressure ventilation (NIPPV), nonpositive pressure ventilation (NPPV), and mechanical ventilation not otherwise specified...The code titles for category 96.7 and codes listed under this category have been revised to clarify that these codes are for continuous invasive mechanical ventilation. Inclusion terms have been added to indicate that this subcategory is for mechanical ventilation delivered through an invasive interface.
4Q2014: [trach mask question] Oxygen delivered via a tracheal mask is not mechanical ventilation. It is a method to provide supplemental oxygen. A tracheostomy tube (T-tube) fits inside the stoma and is secured by a harness to the neck. The T-tube may be used by some patients in need of oxygen therapy. Oxygen can be delivered directly through the tracheostomy via a T-tube or a tracheal mask placed directly to the stoma. Mechanical ventilation delivered via a tracheal tube directly into the stoma would be coded as mechanical ventilation.
Appreciate any insights.
Renee
Linda Renee Brown, RN, MA, CCDS, CCS, CDIP
Director, Clinical Documentation, Core Measures and Outcomes
Tanner Health System
Would you code this as:
96.72, mechanical ventilation > 96 hours, or
93.90, noninvasive mechanical ventilation.
Coding clinics say:
4Q2008: The code title for code 93.90 has been revised to "Noninvasive mechanical ventilation." Mechanical ventilation is classified as noninvasive (93.90) when delivered via a noninvasive interface like a face mask, nasal mask, nasal pillow, oral mouthpiece or oronasal mask, or without an endotracheal tube or tracheostomy. Types of respiratory assistance considered noninvasive mechanical ventilation include continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), noninvasive positive pressure ventilation (NIPPV), nonpositive pressure ventilation (NPPV), and mechanical ventilation not otherwise specified...The code titles for category 96.7 and codes listed under this category have been revised to clarify that these codes are for continuous invasive mechanical ventilation. Inclusion terms have been added to indicate that this subcategory is for mechanical ventilation delivered through an invasive interface.
4Q2014: [trach mask question] Oxygen delivered via a tracheal mask is not mechanical ventilation. It is a method to provide supplemental oxygen. A tracheostomy tube (T-tube) fits inside the stoma and is secured by a harness to the neck. The T-tube may be used by some patients in need of oxygen therapy. Oxygen can be delivered directly through the tracheostomy via a T-tube or a tracheal mask placed directly to the stoma. Mechanical ventilation delivered via a tracheal tube directly into the stoma would be coded as mechanical ventilation.
Appreciate any insights.
Renee
Linda Renee Brown, RN, MA, CCDS, CCS, CDIP
Director, Clinical Documentation, Core Measures and Outcomes
Tanner Health System
Comments
Juli
It seem like there is no mechanical ventilation?? am I missing something?
Thanks,
Renee
Linda Renee Brown, RN, MA, CCDS, CCS, CDIP
Director, Clinical Documentation, Core Measures and Outcomes
Tanner Health System