Rely on CPT Codes to Bridge the PR Payment Gap
Published on Mon Jun 01, 2009
When G codes are off limits, consider coding for inhalation treatments and chest manipulation. If you are like many practices nationwide, you face pulmonary rehabilitation reimbursement challenges that may even restrict whether you offer this service. Here's the skinny on what you can report in the absence of a national coverage determination (NCD): Good news: If you can't report G codes because your local Medicare Administrative Contractor (MAC) doesn't cover PR services or you aren't a contracted provider, opt for CPT Codes to report whatever took place on that particular day, points out Carol Pohlig, BSN, RN, CPC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia. Procedures that your pulmonologist might have performed include: • 94010 -- Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation • 94060 -- Bronchodilation responsiveness, spirometry as in 94010, pre- [...]