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Official Description

Continuous positive airway pressure ventilation (CPAP), initiation and management

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Continuous positive airway pressure (CPAP) ventilation is a therapeutic intervention primarily utilized for the management of sleep apnea, a condition characterized by repeated interruptions in breathing during sleep. This method may also be indicated for preterm infants whose pulmonary systems are not fully developed, thereby requiring assistance to maintain adequate respiratory function. The CPAP system consists of a mask or other breathing apparatus that securely fits over the patient's nose and mouth, connected by a tube to a CPAP machine. This machine is designed to deliver a continuous flow of air at a low pressure, which serves to keep the airways open. By maintaining this positive airway pressure, CPAP effectively prevents the mechanical obstruction of airflow that can occur due to the relaxation and collapse of airway structures during sleep. The CPT® Code 94660 specifically pertains to the initiation and management of CPAP therapy, encompassing the initial setup of the device and ongoing management of the patient's treatment. A durable medical equipment provider is responsible for delivering the CPAP device and any necessary accessories to the patient's home or a residential care facility. During the setup process, the device is configured according to the specifications outlined in a written prescription from a physician or qualified healthcare professional. Furthermore, the patient or their caregiver receives comprehensive instructions on the proper use of the CPAP system, which includes a demonstration of the correct placement of the mask and the operation of the machine to ensure effective therapy.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Continuous positive airway pressure (CPAP) ventilation is indicated for the following conditions:

  • Sleep Apnea The primary indication for CPAP therapy is the treatment of obstructive sleep apnea, a disorder where breathing repeatedly stops and starts during sleep due to airway obstruction.
  • Preterm Infants CPAP may also be prescribed for preterm infants who require respiratory support due to underdeveloped lungs, helping to maintain adequate oxygenation and ventilation.

2. Procedure

The procedure for initiating and managing CPAP therapy involves several key steps:

  • Step 1: Prescription and Assessment The process begins with a physician or qualified healthcare professional evaluating the patient and determining the need for CPAP therapy. A written prescription is then provided, detailing the specific settings and requirements for the CPAP device.
  • Step 2: Delivery of Equipment A durable medical equipment provider is responsible for delivering the CPAP machine and any necessary accessories, such as masks and tubing, to the patient's home or a residential facility.
  • Step 3: Setup of CPAP Device Upon delivery, the CPAP device is set up and programmed according to the specifications outlined in the prescription. This includes adjusting the pressure settings to ensure optimal therapeutic benefit for the patient.
  • Step 4: Patient Education The patient or caregiver receives thorough instructions on the correct use of the CPAP system. This education covers how to properly fit the mask, operate the machine, and maintain the equipment.
  • Step 5: Demonstration of Use To confirm understanding, the patient or caregiver is asked to demonstrate the correct placement of the mask over the mouth and nose and to turn on the CPAP machine, ensuring they are comfortable with the operation of the device.

3. Post-Procedure

After the initiation of CPAP therapy, ongoing management is essential to ensure the effectiveness of the treatment. Patients are typically monitored for adherence to therapy and any potential side effects. Follow-up appointments may be scheduled to assess the patient's response to CPAP, make necessary adjustments to the device settings, and address any concerns regarding comfort or usability. Regular maintenance of the CPAP equipment is also important, including cleaning the mask and tubing to prevent infections and ensure optimal performance of the device.

Short Descr POS AIRWAY PRESSURE CPAP
Medium Descr CPAP VENTILATION CPAP INITIATION&MGMT
Long Descr Continuous positive airway pressure ventilation (CPAP), initiation and management
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator STV-Packaged Codes
Type of Service (TOS) 1 - Medical Care
Berenson-Eggers TOS (BETOS) M2C - Hospital visit - critical care
MUE 1
CCS Clinical Classification 216 - Respiratory intubation and mechanical ventilation
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GC This service has been performed in part by a resident under the direction of a teaching physician
GZ Item or service expected to be denied as not reasonable and necessary
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
24 Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period: the physician or other qualified health care professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. this circumstance may be reported by adding modifier 24 to the appropriate level of e/m service.
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
AF Specialty physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
SA Nurse practitioner rendering service in collaboration with a physician
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
Date
Action
Notes
2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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