Pulmonology Coding Alert

Risk Adjustment:
Learn How One Word Transforms the Complexity of Your Pulmonology Patients
Realize risk scores carry more weight than just reimbursement. If you want to improve you... Read more
Condition Spotlight:
Isolate These Common Smoking, Sleep Apnea, and BMI Dx for American Truck Drivers
More than 50% of truck drivers smoke cigarettes. If your pulmonologist sees a patient who... Read more
ICD-10-CM:
Simplify Flu Manifestations Coding with These 3 Scenarios
Do you code bronchitis separately? Find out. As flu season quickly approaches, now is the... Read more
Reader Questions:
Dig Through the Descriptors to Find Your Sleep Apnea Dx Code
Question: A patient's general practitioner referred them to our pulmonology practice after... Read more
Reader Questions:
Be Mindful of Other Descriptors When Coding Nasal Polyps
Question: Our practice saw a patient who was experiencing inflammation in their nasal cavi... Read more
Reader Questions:
Prepare Your Pleural Infection Coding Skills
Question: I have a report from a physician in our practice from their encounter with a pat... Read more
Reader Questions:
Assess the Patient’s Age for Spirometry Coding
Question: A pediatrician referred an 18-month-old patient to our pulmonology practice for ... Read more
You Be the Coder:
Remember the 4th Character for COPD Coding
Question: One of the pulmonologists in our practice examined a patient during a follow-up ... Read more
CPT® 2022 Update:
Familiarize Yourself with Principal Care Management Codes Prior to Jan. 1
Prepare to revise the way you report 99211. Are you nervous that you'll have to utilize a... Read more
Medicare 101:
Get Up to Speed with These 5 Medicare Tips
Follow these keys to transition to Medicare smoothly. If a new provider or coder is joini... Read more
ICD-10-CM:
Sift Through These Symptoms to Reveal Rare Lung Diseases
Find the right occupation to code a hypersensitivity pneumonitis dx. You'll find a bevy ... Read more
Reader Questions:
Don’t Quit on 99406 and 99407 When Reporting Smoking Cessation Claims
Question: I have a physician's report that indicates they spent time with the patient disc... Read more
Reader Questions:
Code an Accurate Sports Exam Following COVID-19
Question: We have a college student who came in for a physical examination to participate ... Read more
Reader Questions:
Can Supplying Free Samples Land You in a Legal Battle? Find Out.
Question: In the past, pulmonologists in our practice have frequently supplied free sample... Read more
You Be the Coder:
Carefully Read Documentation to Know if Combo Codes Apply
Question: I have a physician's note that documents the patient's conditions as acute respi... Read more
CPT®:
Simplify Your EBUS Billing Claims by Highlighting Lymph Node Stations
Knowing the number of lymph node stations examined determines your code selection. Billi... Read more
Mythbusters:
Bust These Myths to Strengthen Your Modifier Coding Skills
Hint: Clear documentation will back up your modifier 25 claims. How do you correctly bill... Read more
ICD-10-CM Coding Quiz:
Dive Into the Descriptors to Understand the Differences in Bronchitis Codes
Learn the difference between J41.0 and J20 bronchitis codes. The respiratory system consi... Read more
You Be the Coder:
Know the Difference Between 99441-99443 Telehealth E/M Visit CPT® Codes
Question: To cut down on the number of patients in our office during the COVID-19 pandemic... Read more
Reader Questions:
What Critical Care Services are Bundled into 99291? Find Out.
Question: I'm new to pulmonology, and I received a critical care report from the physician... Read more
Reader Questions:
Coding COVID-19 Vaccine Side Effects Doesn’t Require Special Treatment
Question: If a patient presents to the emergency department after complaining of hives and... Read more
Reader Questions:
Pay Attention to the 4th Character When Coding Rare Lung Diseases
Question: A 50-year-old patient came into our pulmonology practice presenting with breathi... Read more
ICD-10-CM Update:
Get Ready for Revised COVID-19 and New Cough Dx Codes Before Oct. 1 Hits
Converted and added codes indicate how you'll document cough diagnoses. The Centers for D... Read more
ICD-10-CM Update:
Documenting Social Determinants of Health Can Factor Into Your Care Plan
2022 ICD-10-CM Z code revisions focus on housing insecurity, food insecurity, and more. Y... Read more
Reimbursement:
CMS Proposes Billable Split/Shared Visits for Critical Care Services
Plus: Post-COVID telehealth options may get extended. Pulmonology practices have been ant... Read more
You Be the Coder:
Know How to Code Diskus at an E/M Visit
Question: An established patient comes in for a routine evaluation and management (E/M) vi... Read more
Reader Questions:
The Distinct Phases of Dysphagia Determine the Correct Codes
Question: If the provider documents different phases of dysphagia, do you code the phases ... Read more
Reader Questions:
Defining Acute vs. Chronic Will Determine Your Pansinusitis Coding
Question: I have an op note that documents the patient's condition as “pansinusitis.” ... Read more
Reader Questions:
Check Descriptors for Spirometry Tests and Bronchodilation
Question: I have an established patient who came in for a follow-up visit after an episode... Read more
Coding 101:
Breathe New Life into Your Exercise-Induced Asthma Coding Skills
Do you need to report J45.2- with J45.990? Find out. Summer is in full swing and with kid... Read more
HIPAA:
Check These Key Insights to Stay Ahead of a Privacy Breach
There doesn't appear to be a slowdown in HIPAA violation fines anytime soon. Have you bee... Read more
E/M Coding:
5 Tips Demonstrate How to Make the Most of Your MD’s 99211 Visits
No face-to-face time with nurse or physician? Find out if this qualifies. Is your pulmono... Read more
You Be the Coder:
Can You Report URI and Bronchitis on One Report? Find Out
Question: I have an op report that says the patient has bronchitis and URI. Can I submit t... Read more
Reader Questions:
Get the Scoop on Bronchoscopy Coding
Question: Our pulmonologist biopsied and brushed the same lesion during a bronchoscopy. Ca... Read more
Reader Questions:
Report Your Diagnosis Code Based on Documentation — Always
Question: I've just started coding for a pulmonary practice, and I'm having some trouble w... Read more
Reader Questions:
Sore Throat Codes Depend on the Details
Question: My pulmonologist's documentation mentions that the patient is presenting symptom... Read more
Reader Questions:
A Patient’s Passing Doesn’t Void Privacy Rules
Question: If a patient passes away, how long does my practice need to maintain their priva... Read more
Reader Questions:
Delve Into Rules Regarding Scribes
Question: We just started having one of our medical assistant's act as a scribe for a phys... Read more
ICD-10 Coding:
How to Narrow 50+ Pneumonia Diagnosis Codes Down to the Most Specific Option
Know pneumonia's cause before selecting a code, experts say. When should your pneumonia c... Read more
Incident-To Coding:
5 Tips for Billing Incident-To Services
Hint: Don't meet the requirements? Bill under the APP's NPI. When you're reporting incide... Read more
Coding Accuracy:
Boost Your Bottom Line With These Self-Audit Tips
Check in on your practice's coding accuracy to ensure you're on the straight and narrow. ... Read more
Clip And Save:
Guide Your Self-Audits With This Quick Checklist
Pulmonology coders who have never performed a self-audit may wonder whether they have what... Read more
Reader Questions:
Set a Schedule to Avoid Seeing Denials Pile Up
Question: We performed a self-audit two months ago and identified over a dozen denied clai... Read more
Reader Questions:
Denote Corrections Even in EHR
Question: We are aware of how to correct a mistake on a paper medical record, but how do w... Read more
You Be the Coder:
Know What Constitutes ‘Established’ Patient
Question: We have a cardiothoracic surgeon and a cardiologist on staff at our multispecial... Read more
E/M Coding:
Can You Code These Pulmonology-Focused E/M Case Studies?
It's a good time to confirm that your 2021 E/M coding skills are up to the task. You spen... Read more
Modifiers:
Use Modifier 22 to Unlock Pay for This Complex Op Note
Hint: Be ready to justify the reasons you went beyond the code descriptor. As everyone in... Read more
Make Your Modifier 22 Case With These Tips
Extra effort, time are important, experts say. Before sending that modifier 22 (Increased... Read more
Reader Questions:
Stay in ‘J’ Section of ICD-10 for Associated COPD Conditions
Question: Thanks for your guide to COPD diagnoses last month — we were particularly inte... Read more
Reader Questions:
Don’t Discard Remittance Advice
Question: We received provider remittance advice from an insurance company. What can we do... Read more
Reader Questions:
Assess PHI Risk When Calling Patient Names
Question: Is it OK to call out full names in a waiting room? Can you ask for “John Smith... Read more
Reader Questions:
Inpatient E/M Services Are Billable Under Telehealth
Question: Can we report inpatient telehealth E/M services to Medicare? This has happened i... Read more
Reader Questions:
In Which Settings Can We Report Critical Care?
Question: We often perform critical care (99291-+99292) for our pulmonologists who do roun... Read more
Reader Questions:
Discover How to Respond to Demand Letter
Question: Our practice just received a “demand letter” from our Medicare Administrativ... Read more
You Be the Coder:
Can You Report CPAP Interpretation?
Question: When a patient brings a CPAP computer drive to the pulmonologist and the pulmono... Read more
ICD-10 Coding:
Test Your COPD Diagnosis Coding Skills With 4 Quick Questions
Find out whether you're an expert COPD coder. Your pulmonology practice is likely to see ... Read more
Documentation:
Check These Documentation Tips — Straight From Part B Reps
Hint: Maintain all records for at least seven years. Documentation is the lifeblood of yo... Read more
Virtual Check-Ins:
Clarify Virtual Check-In Coding With a Few Simple Steps
Unsure how to report G2252? We've got the scoop. You may not have been familiar with vi... Read more
Reader Questions:
Don’t Forget Modifiers With These Services
Question: A 14-year-old established patient presented for a follow-up visit after an episo... Read more
Reader Questions:
Does This Count Toward MDM?
Question: Our pulmonologist advised a patient to continue taking a given medication at the... Read more
Reader Questions:
Request Medical Policies Whenever Possible
Question:  contacted my insurer and asked how they prefer me to submit codes for a pa... Read more
You Be the Coder:
Can You Report Vent Management Appropriately?
Question: Our pulmonologist performed vent management on a critically ill patient. We repo... Read more
HCPCS Level II Coding:
Are You Reporting Albuterol Correctly? Your Payer May Be Watching
Once again, CMS listed J7613 as the most-billed code. Although you may think E/M service... Read more
Part B Coding:
Part B Reps Reveal Answers to FAQs About COVID, MA, and More
Check out the responses to seven pressing questions. Are you already eligible to bill f... Read more
Medicare Provider Enrollment:
Can You Navigate These 4 Provider Enrollment Scenarios?
Yes, you can appeal an enrollment decision. Even if you've been working with the Medicar... Read more
Reader Questions:
How Should You Report Trach Tube Change?
Question: Our nurse practitioner saw a patient in our office this week who required a trac... Read more
Reader Questions:
Get to Know the MDM Guidelines
Question: If a provider is billing an outpatient E/M code based on medical decision making... Read more
Reader Questions:
Iron out 99233 Documentation Rules
Question: In your last issue, you listed the biggest errors that CMS found among Part B c... Read more
You Be the Coder:
Can You Separately Report Lidocaine?
Question: Is there a code we should bill for subcutaneous lidocaine or lidocaine with epin... Read more
Compliance:
CMS: Pulmonologists Responsible for Millions in Incorrect Coding Errors
Medicare reviewers revealed details about the latest Part B E/M improper payment rates. P... Read more
Get a Handle on CMS’ Review Benchmarks
CMS identified a total of $25.74 billion in total improper payments among providers sampl... Read more
Telehealth Coding:
Check These 10 Facts About Telehealth, Straight From Part B Reps
MAC reps answered providers' telehealth questions, and the answers may surprise you. Ha... Read more
ICD-10 Coding:
Solidify Your Pulmonology-Specific Diagnosis Coding With a Few Quick Tips
Don't hesitate to contact the provider when necessary, experts say. Although it's always... Read more
Reader Questions:
Know Where Modifier 59 Should Go
Question: Our pulmonologist gave an inhalation treatment for an exacer­bation and taught ... Read more
Reader Questions:
Some Payers Still Cover Consult Codes
Question: Our pulmonologist performed a consultation in our office with an arthritic patie... Read more
You Be the Coder:
Can You Separately Report Lidocaine?
Question: Is there a code we should bill for subcutaneous lidocaine or lidocaine with epin... Read more
E/M Coding:
8 Concrete Facts About the New E/M Rules
Check these tips that are straight from the mouths of Part B reps. As pulmonology coders... Read more
Part B Payments:
Latest Fee Schedule Delivers Changes to Telehealth List
Plus: The updated fee schedule also includes changes to supervision rules. If you were am... Read more
Reader Questions:
Fee Schedule Includes Details on Payment Amounts
Question: I noticed in your last issue that you shared a typical Medicare reimbursement am... Read more
Reader Questions:
Check This ICD-11 Update
Question: I listened in on a webinar recently where the speaker said to prepare now for I... Read more
You Be the Coder:
Can You Code This Lavage Note?
Question: Our pulmonologist dictated a bronchoscopy note saying, “copious amounts of muc... Read more
ARDS Coding:
Look to ’J’ Codes for ARDS Diagnoses
Remember that ARDS is secondary to COVID-19. Your pulmonologists are likely to address ca... Read more
Get to Know How ARDS May Look in the Documentation
If you're unsure of what an ARDS case might look like when reading documentation, get to k... Read more
Critical Care:
Do You Know When Modifier 25 Applies to Critical Care Codes?
Plus: Documentation must include specific details to report critical care. Do your pulmo... Read more
Clip And Save:
Know What’s Included in the Critical Care Codes
Although there are some services that you can report along with the critical care codes (9... Read more
Patient Privacy:
Ensure That Your Remote Coding Team Keeps Patient Privacy Secure
Tip: Devices must be locked down and protected. Patient privacy has always been at the t... Read more
Reader Questions:
Know the e-Signature Rules
Question: Our practice still sees a majority of our Medicare beneficiaries via telehealth ... Read more
Reader Questions:
COVID Counseling May Be Billable
Question: Our practice is counseling a lot of Medicare beneficiaries about the importance ... Read more
You Be the Coder:
Can You Code This Bronchial Biopsy?
Question: Our pulmonologist performed a bronchoscopy with transbronchial biopsies. He disc... Read more
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