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Pulmonology Coding Alert

Pulmonary Rehabilitation and Respiratory Therapy Services:

Factor 4 Tips Into Your Pulmonary Rehab Service Coding Process

Published on Fri Sep 23, 2011

Limitation: G0424 requires monitored exercise, and an hour's therapy of up to two sessions per day per patient. You can bill a pulmonary rehabilitation (PR) program with an all-inclusive G code, but did you know it must include monitored exercise? Without the necessary essentials, the whole PR coding process will not be an easy task. Check out these related scenarios, and apply four tips to your solutions. Scenario 1: A patient diagnosed with COPD (491.20, Obstructive chronic bronchitis without exacerbation) presents to your office for PR evaluation and planning. The patient receives -- from the pulmonologist -- an initial office assessment, including baseline testing (e.g., six-minute walk, PFTs) to determine the appropriateness and/or treatment plan before initiating PR. The patient then proceeds with 35 minutes of pulmonary rehab. How should you report this? Scenario 2: Throughout the course of the PR program, the same patient reports for follow-up outpatient visits where the [...]
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