Pulmonology Coding Alert

Tip: Present providers with better-paying codes.All the mix and match of coding ventilator management could add to the complexity of appropriately reporting and reimbursing your claims. Let our experts guide you through how to post your claims with accuracy.Note: Medicare contractors implement coding edits in their electronic claims logic, and if you bill the ventilator management code along with an E/M code, Medicare will deny the claim or pay the lesser valued service. Getting paid for both a ventilator management code and an E/M code doesn't occur with Medicare or other payers.Make Up Your Mind: Ventilator Management Code or E/MScenario 1: Your pulmonologist provides ventilator management. The progress notes describe the service as more in line with 99291. But you think 94003 is a better choice.Solution 1: Let the encounter notes lead you to the appropriate code, but you should also consider the relative value units (RVUs) since this reflects [...]