Part B Insider (Multispecialty) Coding Alert

Published on Wed Jun 15, 2011 PDF

Question: How should I bill MIPs (maximum inspiratory pressures) or MEPs (maximum expiratory pressures)? My pulmonary technician has been asked to do this test. She knows how to do the test, but we can't find the code to bill for it.

Answer: You will need to use code 94799 (Unlisted pulmonary service or procedure) since there is no code specific for these tests. MIP and MEP would be covered when the documentation supports an acute condition and the medical necessity of the service is documented. Make sure you include an accurate service description on the claim form along with an anticipated fee. If the claim is initially denied or suspended pending record review, be sure to submit the documentation.