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Pulmonology Coding Alert

CPT 2001 Reveals Pulmonology Code Changes That Simplify Coding and Increase Payment
The CPT 2001 manual reveals a few changes in codes that pulmonary billing specialists use... Read more
Modifier -60 Gets Payment for Work on Altered Surgical Field
CPT 2001s new modifier -60 could be good news for chest surgeons and their coders. Until ... Read more
OIG Targets ABNs in 2001
If youre about to perform a procedure that your carrier may not consider medically necessa... Read more
Reader Question:
Methacholine Challenges
Question: Our doctor is exploring doing methacholine challenges in the office, and he has ... Read more
Reader Question:
Oximetry
Question: Medicare states that they dont cover 94760 unless its the only service done. If... Read more
Reader Question:
Adjustment to Tracheotomy
Question: What code do I use for therapeutic adjustment to tracheotomy size (a tube change... Read more
Reader Question:
Consultation
Question: One of my doctors recently heard that we should use a consultation code, such as... Read more
Reader Question:
Swan-Ganz Catheter
Question: One of our doctors performed a Swan-Ganz catheter procedure, but complications... Read more
You Be the Coder:
Bronchoscopy
Question: Our clinic admits a 90-year-old male Medicare patient with pulmonary infiltrat... Read more
Critical Care Reimbursement Relief Coming in January 2001
The Health Care Financing Administration (HCFA) has promised to eliminate the 10 percent... Read more
Care Plan Oversight:
Billing for Home Healthcare
Pulmonologists often provide care plan oversight (CPO) services to patients with lung dise... Read more
Fall Brings Flu Shots You Can Get Paid For Them
With the approach of fall, many patients are requesting flu and pneumonia shots as an insu... Read more
Say Goodbye to Black Box Edits and Unexplained Denials
If youve received denials for bills youve submitted for pulmonary care services with no re... Read more
Reader Question:
Critical Care and Bronchoscopy
Question: Can we bill critical care and bronchoscopy on the same day? Is a modifier requir... Read more
Reader Question:
Oximetry Reading
Question: How can I get reimbursed for an oximetry reading (CPT 94760 ) and an office eval... Read more
Reader Question:
Modifier -51
Question: Can any of the codes from CPT 31622 to CPT 31626 be billed together with modif... Read more
Reader Question:
Bronchoscopy
Question: How do I bill bronchoscopy with transbronchial needle aspiration of multiple sit... Read more
Reader Question:
Rounding Limiting Charges
Question: Is it true that a non-participating Medicare provider can round the limiting cha... Read more
Reader Question:
Homebound Standard
Question: We are in a rural area and sometimes make house calls. Do Medicare patients have... Read more
You Be the Coder:
Tracheostomy
Question: A patient had a percutaneous dilational tracheostomy at a clinic. The patient is... Read more
Optimize Reimbursement for Screening and Therapeutic Thoracentesis Procedures
Thoracentesis may be performed either for diagnosis or therapeutic purposes, and also may ... Read more
Code Inhalation Treatments for Optimal Reimbursement
An acute asthmatic (ICD-9 493.00 - 493.91 ) patient experiencing a bronchospasm presents t... Read more
How to Code Adverse Effects From Pulmonary Medications
Pulmonologists should code the treatment of adverse effects from medication based on wheth... Read more
Reader Question:
Team Meetings
Question: Our pulmonologist treats an asthmatic (ICD-9 493.00 -ICD-9 493.91 ) patient who ... Read more
Reader Question:
Travel Advice
Question: One of our asthma patients, who is self-administering Proventil, was planning a ... Read more
Reader Question:
Death Certificate
Question: A patient that I admitted to a skilled nursing facility in January passed away i... Read more
Reader Question:
Interrupted Perfusion Imaging
Question: We were performing CPT 78588 (pulmonary perfusion imaging, particulate, with ve... Read more
You Be the Coder:
Preoperative Physical
Question: What is the correct method to bill a presurgical physical (99243, office consult... Read more
Code Carefully When Providing Other Services On the Same Date as Critical Care
Many subscribers are unclear about the specifics of hospital coding for pulmonary care, s... Read more
Avoid the Pitfalls of Incident to Versus Direct Billing
Address the issue early of how to bill the work of a non-physician practitioner (NPP). If... Read more
Avoid Downcoding by Using Prolonged Service Codes
Pulmonology providers who write off the expense of spending extra time with patients durin... Read more
OIG Issues Guidance for Physician Practices
In June, the Department of Health and Human Services (HHS) Office of Inspector General (... Read more
Reader Question:
Pulmonary Function Test
Question: I have the CPT codes for the various pulmonary function test (PFT) interpretatio... Read more
Reader Question:
Office Tests
Question: What CPT codes should I use for a pulmonology function using a computer function... Read more
Reader Question:
Allergy Injections
Question: How can we get paid for two or more allergy injections (each different medicatio... Read more
You Be the Coder:
Oximetry Reading
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Get Paid for Interpretation of Lab Tests
Pulmonologists often require test results to diagnose illnesses and then determine treatme... Read more
How to Be Paid for Using HBO
Hyperbaric oxygen therapy (HBO) a medical treatment in which a client breathes pure oxyg... Read more
Documentation Key to Avoid OIG Scrutiny for Pneumonia Coding
High on the federal governments hit list is pneumonia upcoding. As part of its workplan fo... Read more
HCFA Launches Hospital OPPS
Early in June, Health Care Financing Administration (HCFA) Administrator Nancy-Ann Min DeP... Read more
Reader Question:
BiPAP and CPAP
Question: We frequently use noninvasive ventilation, bi-level positive airway pressure (Bi... Read more
Reader Question:
Bronchospasm/Spirometry
Question: When billing code 94060 (bronchospasm evaluation: spirometry as in 94010, before... Read more
Reader Question:
Chest Tube Removal
Question: Is there a payable code for removal of chest tube? Nevada Subscriber Answer: The... Read more
Reader Question:
Pulmonary Tests
Question: We perform lung volumes and diffusion capacity in our office, as well as spirome... Read more
Reader Question:
Bronchoscopy
Question: How do I code an extended bronchoscopy with several endobronchial biopsies (bx... Read more
You Be the Coder:
Tracheostomy
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
How to Get Paid for Chest Physical Therapy
The coding most often used for postural drainage and other related chest physical therap... Read more
Documentation Is Key to Proper E/M Reimbursement
During the remainder of this year, the Health Care Financing Administration (HCFA) will b... Read more
Plan Ahead for Proper Sleep Study Reimbursement
Medicare has some very specific criteria that must be met before a sleep study test can qu... Read more
Reader Question:
Pneumonia
Question: The physician states that the primary discharge diagnosis for his hospitalized p... Read more
Reader Question:
CPR
Question: Can we receive reimbursement for cardiopulmonary resuscitation (CPR) if we do no... Read more
Reader Question:
Unbundling
Question: I am trying to code pulmonary function studies. I am being given four codes: 9... Read more
Reader Question:
Tracheostomy Tube Change
Question: What CPT code is appropriate for a tracheotomy tube change when the fistula trac... Read more
Reader Question:
COPD
Question: The doctor sees a patient for chronic obstructive pulmonary disease (COPD) exa... Read more
You Be the Coder:
E/M Visit
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Optimize Reimbursement by Avoiding the Unbundling of Pulmonary Testing Components
Many physicians who initially experienced denial for spirometry (94010) when they billed i... Read more
Correct Coding is Key to Avoid Mislabeling a Patient
After an ICD-9 code is reported on an insurance claim, it enters into the system as a life... Read more
How To Avoid Denials for Ventilation Management Code
Whether you should use the ventilation management codes or the continuous positive airwa... Read more
Reader Question:
Initiate CPAP
Question: Our doctor interprets sleep studies in a hospital outpatient center. If he decid... Read more
Reader Question:
Old Case--New Problem
Question: While covering for one of my colleagues on an old existing case, a new pulmonary... Read more
Reader Question:
Pulmonary Rehabilitation Clinical Trial
Question: As I was reading Medicares Final Rules, I noticed a fee schedule for a Pulmonary... Read more
Reader Question:
Swan-Ganz Catheter
Question: If a patient undergoes the insertion of a Swan-Ganz catheter introducer into a c... Read more
Reader Question:
SNF Injection Reimbursement
Question: Please provide information on the J codes for injections and skilled nursing fac... Read more
You Be the Coder:
Flexible Bronchoscopy
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Screening vs. Medical Necessity:
Optimize Exam Reimbursement
An underlying chronic condition may be creating a problem in a body system apart from the ... Read more
AHIMA Standards Provide Clear Framework for Professionalism
n an effort to promote the highest levels of professional knowledge, service and ethics, t... Read more
Clear Up Nebulizer Code Confusion
A nebulizer, which allows a patient to receive asthma medicine in the mist form, often is ... Read more
Reader Question:
Thoracentesis and Tube Thoracostomy
Question: If a 9-French drainage catheter is placed over a needle into the pleural space t... Read more
Reader Question:
E/M Counseling Services
Question: Can code 90846 be billed by a pulmonologist when he is meeting with family (in t... Read more
Reader Question:
Pulmonary Diagnostic Tests
Question: Are codes 94620 and 94621 considered diagnostic tests?Shirley SykoraWestmont, I... Read more
Reader Question:
Flow Volume Loop and Spirometry
Question: How do I receive reimbursement for billing a flow volume loop (94375) when a spi... Read more
Reader Question:
Pulmonary Function Tests
Question: I have all the CPT codes for the various pulmonary function test (PFT) interpr... Read more
You Be the Coder:
Allergen Immunotherapy
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Modifier 59 Maximizes Separate Procedure Reimbursement
The new Correct Coding Initiative (CCI) revision contains several code edits that rely on ... Read more
Recover the Cost of a Sign-Language Interpreter
Effective communication is essential between health care providers and their patients. A... Read more
CCI Edits Affect Pulmonology Coding
Unbundlingbilling separately for two or more procedures that CPT 2000 combines in one comp... Read more
Reader Question:
Non-clinical Diagnostic Tests
Question: Are codes 94620 (pulmonary stress testing; simple [e.g., prolonged exercise test... Read more
Reader Question:
Hospital Care E/M
Question: The distinction between the documentation requirements for 99231 (subsequent hos... Read more
Reader Question:
Bronchoscopy
Question: The February Pulmonology Coding Alert contains a reader question about broncho... Read more
You Be the Coder:
Test Interpretation Billing
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Maximize Pay Up for Allergy Immunotherapy Billing for Each Service Rendered
Correct code reporting for allergy immunotherapy hinges on understanding that physicians... Read more
Maximize Reimbursement for a Consultation and a Procedure
Modifier -25 is an important coding ally if a physician performs a consultation (evaluatio... Read more
How to Use Perfusion Imaging Codes to Maximize Pay Up
Coding a pulmonary perfusion or ventilation imaging procedure is less challenging after yo... Read more
Reader Question:
Complete Physical
Question: When we see a Medicare patient for a complete physical because of health problem... Read more
Reader Question:
Pre-op EKG
Question: Sometimes a patient comes in for surgery and our doctors order a pre-op EKG or s... Read more
You be the Coder:
Consultations
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Maximize Reimbursement by Coding Methacholine Challenge Tests with Spirometries
You can get paid separately for methacholine challenge tests (94070) and spirometries (94... Read more
Correctly Code Using the New Distinctions for Critical Care
Critical care patients no longer need always be considered unstable critically ill or unst... Read more
Optimize Payup for E/M Codes With Solid Documentation
Pulmonology practices can optimize reimbursement for evaluation and management (E/M) servi... Read more
Reader Question:
Postopeative Care
Question: If a physician asks you to take care of his patient postoperatively, do you bill... Read more
Reader Question:
Medicare Billing
Question: How do we properly code with modifiers for the following procedures on a Medicar... Read more
You Be the Coder:
Asthma Education
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Medical Necessity Key to Getting Paid for Pulse Oximetry
Despite Medicares recent decision to end separate pulse oximetry reimbursement, it is pos... Read more
Split Results in Two Codes for Pulmonary Stress Testing
Medicare has recently accepted recommendations to split HCPCS code 94620 (pulmonary stress... Read more
Three Keys to Code Consults vs. Referrals
Consultant codes are initiated when one physician requests an opinion or advice from anoth... Read more
Reader Question:
Coding for Plethysmography
Question: When our physician performs a plethysmography, we bill a 93720 (plethysmography,... Read more
Reader Question:
Lung Volume Report
Question: What is the correct code to bill for the reading of a lung volume report/study? ... Read more
Reader Question:
Flu and Pneumonia Shots
Question: How do you get reimbursement for flu or pneumonia shots administered on the same... Read more
You Be the Coder:
Critical Care Coding
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Available Years:  2000