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Pulmonology Coding Alert

Pay Attention to 94010 and 94060 Bundles to Avoid PFT Denials
Hint: Ask about test details when your pulmonologist orders PFTs Pulmonologists often... Read more
Decipher BALs From Basic Washings to Pick Your Code
Learn the basics to achieve flawless bronchoscopy codingWhen your pulmonologist performs a... Read more
Correction:
Use This Chart to Learn the Minimum Criteria for Reporting 99213, 99214
Our September Clip and Save "Use This Handy Chart to Nail Down Elements of 99213, 99214" i... Read more
Rely on Modifier 25 to Report Same-Day E/Ms Properly
Learn why 24 and 57 are most likely not appropriate modifiersWhen you need to report an E/... Read more
READER QUESTIONS:
J7699 Is the Only Option for Histamine Challenges
Question: Would you tell me what codes I should report for the histamines used in a histam... Read more
READER QUESTIONS:
Report Polysomnography and Next-Day MSLTs
Question: My patients often receive polysomnography followed by MSLT the next day. Can we ... Read more
READER QUESTIONS:
Infusion Denial May Depend on Carrier Regs
Question: My doctor started an infusion procedure on an established patient in an outpatie... Read more
You Be the Coder:
Know Your Limits on Prostacyclin Challenges
Question: My pulmonologist wants to bill for a prostacyclin challenge test. He performed t... Read more
Coding Sleep Studies Need Not Be a Nightmare
Know the difference between 95805-95807, 95808-95811To code effectively for your pulmonolo... Read more
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Review This Sample Sleep Study Report for Parameter Documentation
How you report a polysomnography test depends on the documentation you have. Here's a samp... Read more
Don't Let V Codes Always Fall Into Second Place
Our experts show you the codes you can report as primary diagnosesIf you think that you ca... Read more
NCCI 11.3 Update:
You Only Need to Worry About 4 Nonmutually Exclusive Edits
None of the deletions affect your pulmonology codingThe latest National Correct Coding Ini... Read more
READER QUESTIONS:
Phone Calls May Be Critical
Question: I am looking for information regarding critical care coding. Would you please ad... Read more
READER QUESTIONS:
Check Individual Carrier Coverage of Oximetry
Question: Under what circumstances will insurers reimburse 94760? Can we report this code ... Read more
READER QUESTIONS:
Use Caution Coding Multiple Stent Insertions
Question: How would I code for the following scenario? My pulmonologist inserts a bronchos... Read more
READER QUESTIONS:
Saline Documentation Helps Your Coding
Question: Is it necessary for my pulmonologist to document saline usage, or the amount of ... Read more
READER QUESTIONS:
Seek Reimbursement for Preventive Counseling
Question: If a patient sees my pulmonologist just for counseling and does not have an esta... Read more
READER QUESTIONS:
Use E/M Code for Separate Services
Question: We have several patients who come in for allergy injections but also have other ... Read more
You Be the Coder:
Differentiate Between 491.20 and 491.21
Question: The pulmonologists I work with have several patients with exacerbation of COPD. ... Read more
You'll Breathe Easier With These Tips for Xolair Reimbursement
Know the differences between 90782 and G0355 To record accurately the additional drug prep... Read more
Reporting Pneumo Vaccines? Keep 99211 Separate
The chief complaint and treatment plan can change everything Identify a significant, separ... Read more
A Quick Check of 99211 Requirements Will Guarantee Payment
Follow these 7 guidelines to determine whether 99211 is appropriateIf you're not sure whet... Read more
Light Up Smoking Cessation Claims With New G Codes
Learn to how to capitalize on smoking cessation counseling reimbursement Confused by the c... Read more
Reader Questions:
94620 Does the Talking for 6-Minute Walk Tests
Question: I'm confused about whether pre- and post-spirometry is required when I report 94... Read more
Reader Questions:
Requests Are Required for Consultation Coding
Question: My pulmonologist had a patient schedule his own appointment and come into the of... Read more
Reader Questions:
Save ICD-9 Codes for Established Diagnoses
Question: One of the pulmonologists in my practice saw a patient in consultation at the ho... Read more
Reader Questions:
Documentation Is Crucial for Unlisted Procedures
Question: How do insurers determine reimbursement when I report an unlisted-procedure code... Read more
You Be the Coder:
Report Both Nebulizer Treatments and Education
Question: My pulmonologist saw an established patient who was newly diagnosed with asthma ... Read more
Case Study, Part III:
Look at the Big Picture to Justify Modifier 22
If the pulmonologist notes additional bronchoscopies, your reporting should respond accord... Read more
Need Help Choosing Correct E/M Levels? CMS Settles the Score
The pulmonologist's order may count for more than you thinkWith advice from CMS and our co... Read more
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Use This Handy Chart to Nail Down Elements of 99213, 99214
Knowing the code's minimum criteria is more than half the battle Document every procedure ... Read more
READER QUESTIONS:
Query Doctor for Critical Care Time
Question: We have a critical care claim involving a patient in respiratory distress in whi... Read more
READER QUESTIONS:
Physicians Must OK Incident-To Services
Question: My coworker thinks a pulmonologist must take a patient's history, but I think a ... Read more
READER QUESTIONS:
Update Doctor's Number, Not Incident-to Coding
Question: Will the new National Provider Identifier (NPI) change how we report services in... Read more
READER QUESTIONS:
Ask Payers Before You Report 99071
Question: Is there a way we can offset the cost of educational materials, pamphlets, etc.,... Read more
READER QUESTIONS:
Double-Check When Reporting RSV Codes
Question: When we report 99291 for in-office critical care in addition to influenza and RS... Read more
READER QUESTIONS:
Observing for a Second Day? Read On
Question: I've heard that I can bill the "middle" day of observation as an outpatient offi... Read more
You Be the Coder:
Code Pneumonia Diagnosis to the Highest Level
Question: The pulmonologist was treating an inpatient for apparent pneumonia. The culture ... Read more
NCCI 11.2 Update:
Get Ready for More Than 800 Nonmutually Exclusive Bundles
Modifier 59 helps you report 3 G codes accurately A trio of injection and intravenous push... Read more
Case Study, Part II:
Consider More Than Just Time For Critical Care Coding
When your pulmonologist records critical care time with multiple procedures, don't stop at... Read more
Simple Method for Choosing the Correct Observation Care Code
8 hours may make or break your 99218 reporting Your pulmonologist's service date(s) and le... Read more
Same-Session Teaching and Nebulization Can Pay the Bills
Experts help you ease your inhaler demonstration reimbursement woes If you find yourself s... Read more
8 Hours May Fly by for Observation Cases, But Don't Cut Your Reimbursement Short
    Here's a handy tool to help you keep charge and discharge details straight&... Read more
Reader Questions:
Look Death in the Face for Appropriate Discharges
Question: A nursing facility called our pulmonologist because one of our established patie... Read more
Reader Questions:
Avoid Undefined Asthma and Assign the 5th Digit
Question: An elderly patient came to our practice with a history of asthma-induced bronchi... Read more
Reader Questions:
In the Absence of Details, Stick With What's on Paper
Question: The E/M guideline chart that we use to select the level of history includes iden... Read more
You Be the Coder:
Append 76 for Multiple Nebulizer Treatments
Question: A patient with acute asthma requires three same-visit nebulizer treatments to co... Read more
ICD-9 Update:
New Sleep Apnea Codes Will Awaken Your Sleep Disorder Reporting
The 2006 codes allow you to justify sleep studies for your obese patients Have you be... Read more
Case Study, Part I:
Avoid Common Coding Snafus For Multiple Bronchoscopies
Use -25 if your physician provides other services with 99255 Pulmonologists frequently per... Read more
Consider -22 for Services Beyond CPT's Scope of Work
Tally the value of your physician's extra work for unusual procedures When your pulmonolog... Read more
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Keep This Checklist Close at Hand to Nail Your -22 Claims
4 simple tips will build a stronger case for unusual-procedure charges If you plan to subm... Read more
Reader Questions:
Status Shouldn't Impact 99221-99223 Reporting
Question: An insurance representative recommended at an in-house seminar that if our pulmo... Read more
Reader Questions:
Watch Reporting Consults With 94656
Question: A pulmonologist in our practice completed an inpatient consultation, an initial ... Read more
You Be the Coder:
Same-Day Discharge May Still Justify 99234
Question: The pulmonologist performed an outpatient bronchoscopy with bronchial biopsy (31... Read more
Watch the Spring Showers Bring on Bundles of Pay for All Your Critical Allergy Cases
Test your knowledge against the following scenario and see if you make the anaphylaxis A+ ... Read more
HCPCS 2005 Update:
Administering Combination Nebulizer Meds? Read On
Now CMS makes it easier for you to report compound solutions Just when you thought the exc... Read more
Correction:
Modifiers -26 and -TC
The March 2005 Pulmonology Coding Alert article titled "Follow This Modifier -26 and -TC D... Read more
Learn the Difference Between -50, -LT and -RT
Modifier -50 can bring your practice 150 percent of the fee schedule amount You could be ... Read more
Clip-and-Save Chart:
Use This Simple Tool to Keep the Bilateral Billing Rules at Your Fingertips
If you're tired of flipping though the Medicare Physician Fee Schedule for advice every ti... Read more
Reader Questions:
Keep ECGs and MSLTs Straight
Question: Do carriers consider a 24-hour ECG part of a polysomnography or MSLT? We have so... Read more
Reader Questions:
Modifier -78 May Remedy Multiple Physician Pay
Question: If physician 1 in our group practice provides post-op care for a patient whom ph... Read more
Reader Questions:
Capture All Services With Allergy Injections
Question: Which code should we report when the doctor spends 15-20 minutes observing the p... Read more
Reader Questions:
Think Twice When Reporting 93720 and PFTs
Question: Can I bill Medicare for code 93720 in addition to the other PFT codes?Oregon Sub... Read more
You Be the Coder:
Don't Overlook the 2-Step Process for 86580
Question: Does anyone bill for purified protein derivative (PPD) interpretation? If so, wo... Read more
3 Scenarios Boost Your Nebulizer Coding Knowledge
J codes offer you the option of billing for albuterol - but not without a hitch Your pulm... Read more
NCCI Update:
Recent Edits May Have Little Effect on Your 94060 Reporting
Note the new bronchospasm and push-drug designation The upcoming National Correct Coding I... Read more
Refer to This List to Stay on Top of Your Latest J Codes
Take a peek at the inhalation solution codesWhile you're updating your infusion codes, mak... Read more
Don't Underestimate the Value of Longer-Than-Usual Appointments
Always report add-on codes with an E/M service and recoup full pay If you find that your p... Read more
Remember, Face-to-Face Time Is Cumulative, Not Continuous
Here's a claim example that should help ease your prolonged service cases Just because you... Read more
Reader Questions:
Believe It or Not - You May Not Always Charge
Question: When a patient brings a CPAP computer card to the pulmonologist and the pulmonol... Read more
Reader Questions:
Don't Bill Separately for Catheter Drainage
Question: A patient comes to our office for follow-up on a pleural catheter (32019) our pu... Read more
Reader Questions:
Laryngoscopy: Choose Direct Versus Indirect
Question: What's the difference between indirect and direct laryngoscopy, and how should I... Read more
Reader Questions:
2 Biopsies in 2 Areas Require Modifier -59
Question: One of our physicians wants to report 31623, 31625 and 31629 for the same bronch... Read more
Reader Questions:
Observation Admit Codes Do Have a Limit
Question: Another doctor asked my pulmonologist for a consult with a patient who had been ... Read more
You Be the Coder When Reporting 31624, Details Matter
Question: The pulmonologist in our practice performed a transbronchial biopsy in the patie... Read more
Case Study:
Put Your Bronchoscopy Coding Knowledge to The Test
One example illustrates that you don't always have to append modifier -51 with 31624 To re... Read more
Capture Everyone's Work With Newly Clarified Incident-To Rules
Make sure you know who is your supervising doctor on duty If your pulmonology practice use... Read more
Distinguish Between Consults And Referrals:
Here's How
Don't underestimate the value of one doctor asking another doctor for his opinion If your... Read more
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Setting Makes All the Difference When You Report Respiratory Therapy Services
Use this tool to make sure you don't leave out dx codes and cut your bottom line Respirato... Read more
Reader Questions:
Sleep May Not Justify Medical Necessity
Question: When the pulmonologist in our practice completes bronchoscopies and sleep studie... Read more
Reader Questions:
Consider Plan of Service for Asthma Dx
Question: A 12-year-old presents with bronchitis with a history of asthma. Should I report... Read more
Reader Questions:
You Can Overlook Time Limits With Consults
Question: If I perform an office consultation on a patient, how much time must elapse befo... Read more
Reader Questions:
31624 May Cover All Services
Question: I know that the National Correct Coding Initiative allows us to bill 31624 with ... Read more
You Be the Coder:
Multiple Tube Changes
Question: The CPT Assistant indicates that I should report 31502 for complicated tracheost... Read more
Don't Let X-Ray Reread Rules Turn You
Learn when to report modifiers -26 and -77 with 71010Even if your physician orders and int... Read more
Modifier Tip:
Remember to Use -26 for Interpretation and Report
And don't overlook location of test administration to increase coding accuracyIf you find ... Read more
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Follow This Modifier -26 and -TC Decision Matrix to Nail the Correct Code Every Time
Find the right code based on who, what and whenWalk your way up the ladder of successful p... Read more
Heed Warnings to Avoid Common Pneumonia Coding Snafus
Scan the note for dx test details before you assign 480-486Turn those pneumonia frowns ups... Read more
Reader Questions:
Dx Determines Lower Lung Infection
Question: Would you please tell me the code for lower respiratory infection?Maryland Subsc... Read more
READER QUESTIONS:
94060 Covers More Than You Think
Question: I know that CPT changed 94664 to demonstrate and instruct the use of bronchodila... Read more
READER QUESTIONS:
Do 99070 and Medicare Mix? Maybe Not
Question: Would you please explain the basics of reporting code 99070?Maryland Subscriber ... Read more
READER QUESTIONS:
Consider NPPs for Counseling Services
Question: Should we consider time as a factor when billing for educational/counseling serv... Read more
READER QUESTIONS:
Previous Hospital Care May Affect E/M Reporting
Question: A provider insurance representative recommended at an in-house seminar that when... Read more
You Be the Coder:
Pay Attention to 'T' Status With 94760
Question: Our technicians conduct oxygen shunt studies in which they give the patient 100 ... Read more
NCCI Update:
NCCI 11.0 Edits Will Change Your 31622 Reporting
12 new bundles shed new light on appending modifier -59 to bronchoscopy codes in 2005 When... Read more
Billing 99291-99296? Follow This Decision Tree
Choose critical care code based on location, age, and setting If you're not sure which cod... Read more
Private vs. Medicare Post-Op Infection Requirements? Read On
Learn the differences and save your practice from denials Coding for post-op infections c... Read more
Reader Questions:
Are Family Consults a Patient Service? Read On
Question: A patient comes in to discuss the care of his wife, who is also a patient and wh... Read more
Reader Questions:
Using Mod -25 May Come With A Price
Question: In your December 2004 issue, you advised us to attach modifier -25 to the E/M co... Read more
Reader Questions:
Don't Let Multiple Steps Trip You Up
Question: Our pathologist receives a lung wedge biopsy for immediate diagnosis. The pathol... Read more
Reader Questions:
A Short Letter Goes A Long Way
Question: Our physician performed a computed tomography (CT)-guided lung tumor ablation. D... Read more
You Be the Coder:
Report One Each For 31632 and 31633
Question: A patient presents with acute respiratory failure. The pulmonologist must obtain... Read more
Case Study:
Always Report a Bronchoscopy With a Thoracotomy? Not So Fast
Scrutinize the note for incision, biopsy details Bronchoscopies and 32100 (Thoracotomy ..... Read more
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This Tool Can Do All the Talking for Your Modifier Claims
Use this flowchart to learn the do's and don'ts of modifier -59 Suppose your physicia... Read more
'1' Matters When You're Reporting Modifier -59
Heightened OIG scrutiny may make or break distinct procedure reimbursements Modifier -59 m... Read more
Coding Quiz:
Test Your 31622 Knowledge
4 scenarios help you improve your bronchoscopy skills Before you report any bronchoscopy p... Read more
Coding Quiz:
Answers to 'Test Your 31622 Knowledge'
Answer 1: For this procedure, you should report 31622 (Bronchoscopy, rigid or flexible, wi... Read more
READER QUESTIONS:
Modifier -52 May Ease Diagnostic Procedure Pay
Question: My surgeon performed a partial lung removal (32480) and a thoracoscopy with lung... Read more
READER QUESTIONS:
Testing for Pneumonia Antibodies? Read This First
Question: Which diagnosis code would be appropriate for a pneumococcal titer lab test?New ... Read more
READER QUESTIONS:
Gastric Contents Might Change Everything
Question: What ICD-9 code should I use for "rule out pulmonary aspiration"? The surgeon di... Read more
READER QUESTIONS:
Location Determines Bronchoscopy Biopsies
Question: When a physician performs a broncho-scopy with biopsies of both the left upper l... Read more
READER QUESTION:
Follow the Law for In-House Lab Services
Question: I am having difficulty getting reimbursed for laboratory services provided in th... Read more
You Be the Coder:
Reporting 99211 With Flu Shots
Question: Can I report a nurse visit (99211) with a flu shot?  Virginia Subscriber An... Read more
Available Years:  2005  2004  2003  2002  2001  2000