CPR is performed when the patient’s heart and lungs suddenly stop. CPR involves the provision of cardiac life support including chest compressions and ventilation of the patient. CPT states 92950 is intended to describe CPR to restore and maintain the patient’s respiration and circulation after cessation of heartbeat and breathing. Basic CPR consists of assessing the victim, opening the airway, restoring breathing (e.g., mouth-to-mouth, bag-valve-mask, etc.), and restoring circulation (e.g., closed chest cardiac massage).

The physician does not have to physically perform the chest compressions or ventilation of the patient, but rather can direct the provision of CPR services. According to the AMA “From a coding perspective, indeed the physician may report 92950 whether he/she is actually performing compressions or ventilation or directing these activities while other staff is actually performing cardiopulmonary resuscitation.”

ACLS involves the provision of drug therapy and possibly defibrillation and these services are reported with the appropriate E/M service, such as 9928X or critical care (99291). CPT states, “In most instances, CPR is performed prior to, with continuation during, advanced life support interventions, e.g., drug therapy and defibrillation, which would be included by reporting the appropriate critical care services code(s) from the E/M section of the CPT codebook.” ACLS does not always require CPR and CPR requires some form of chest compressions and sometimes ventilation that are not a direct component of ACLS

No. CPT lists no minimum or maximum amount of time spent performing and/or supervising CPR as being required to report CPR.

Yes, as long as the respective requirements for each service are satisfied and evident from the medical record. Both CPT and Medicare agree on this point. CPR is a non-E/M service encompassing such activities as supervising or performing chest compressions, adequate ventilation of the patient (e.g., bag-valve-mask), etc. CPT does not list a typical time to qualify for providing CPR. As a separately reportable service with Critical Care, the time spent providing CPR cannot be counted toward calculating total Critical Care time.

Yes. The emergency physician must document a procedure note just like he/she would with any other procedure. It is also possible to report CPR together with a subsequent hospital visit or critical care if the respective E/M performance, time, and documentation requirements are met.

Yes. Other procedures such as intubations, central lines, etc. can be reported in addition to CPR.

In some circumstances and/or for some payers, practitioners may need to indicate that a given episode of CPR and other services are in fact mutually separate and distinct. In such instances, the -25 modifier (appended to E/M services) is usually utilized to distinguish a non-E/M service from E/M services (e.g., Critical Care, ED E/M, etc.) and the -59 modifier is utilized to distinguish one non-E/M service from other non-E/M services (e.g., Intubation, endotracheal, emergency procedure; etc.).