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Pulmonology Coding Alert

Get Paid More When Patients Require Prolonged Care
You'll have to count hospital time differently for Medicare beneficiaries.An expansion of ... Read more
Update Critical Care, Injection, Sleep Codes to Achieve Maximum Compensation
Commit these bundled pediatric codes to memory -- and know when adult care codes ma... Read more
Stick With 76499 for ENB Planning Stage
CPT Assistant's recommendation is a better option than 77299.Instead of letting conflictin... Read more
Skip Modifier 21, Go Straight to 99354-99359 in 2009
You'll have only the more specific way to report prolonged services.Have you tried adding ... Read more
E/M Coding:
3 Tips Are Key to Deciphering 99213 From 99214
Don't raise a red flag: Avoid overuse of this code.Do you recognize when your physician do... Read more
Reader Questions:
Which Codes Are for Multiple Lymph Node Biopsies?
Question: We've been using 31629 and 31633 to code for multiple lymph node biopsies perfor... Read more
Reader Questions:
Does 'Incident to' Apply to Inpatient Consults?
Question: How do you report a consultation performed by a nonphysician practitioner (NPP) ... Read more
Reader Questions:
Can We Use E/M Codes for Built-In Service?
Question: A nurse practitioner (NP) sees a 65-year-old established patient for a pneumonia... Read more
You Be the Coder:
Can You Code E/M From This Referral?
Question: A family practitioner sent a patient to my pulmonologist with a mass on the ches... Read more
Watch the 'Unlisted' Code for ENB
Manufacturer, AMA differ on planning phase's correct coding choice.Be sure you have the fu... Read more
Record Consult Request or Face Claim Denials
Your pulmonologist usually provides pre-, post-op consults.Coders who don't want their con... Read more
Checkpoint:
Know When to Code for Pre-Op Consult
Do you know how to handle preoperative visits when the patient has comorbidities? Check yo... Read more
Test Your Review-of-Systems (ROS) Knowledge
These 3 scenarios will help improve your E/M skills.Before you report any E/M procedures, ... Read more
Reader Questions:
31623 Covers All Brushings
Question: Our pulmonologist completed a bronchoscopy with protected brushings and cytology... Read more
Reader Questions:
Watch Medication Amounts for Rib TPI
Question: My pulmonologist injected Xylocaine and Solu-Medrol into a patient's rib cage. H... Read more
Reader Questions:
2 Hospital Visits: 1 E/M Service or 2?
Question: A private payer representative informed my doctors that they can bill for more t... Read more
Reader Questions:
Report Combo Bronchodilator Drug With J7620
Question: Recently, while working in our urgent care center, our nurse practitioner (NP) a... Read more
Reader Questions:
Code CPAP and Autopap the Same
Question: What is the correct way to code CPAP versus autopap? Should I report them differ... Read more
You Be the Coder:
Know When to Include Chronic Conditions
Question: If the patient has a chronic condition, such as diabetes, should I report that d... Read more
Align Your CPAP Diagnoses and Diagnostic Test Requirements With CMS's New Ways
Your physician's HST notes, test orders will need to contain these itemsThanks to two Medi... Read more
Checking Sleep Apnea? Make Coding as Easy as 1, 2, 3
Stick with attended sleep studies to ensure paymentYou can bolster your polysomnography an... Read more
Reader Questions:
Rely on 'Unlisted' for MIP and MEP Testing
Question: What codes should I submit for MIP and MEP tests?Oklahoma SubscriberAnswer: The ... Read more
Reader Questions:
Look to 76942 for Radiologic Guidance
Question: My physician has begun using radiologic guidance during paracentesis and thorace... Read more
Reader Questions:
Check for Bundles Before Coding Complete PFT
Question: We received a superbill for a "complete PFT" with multiple codes marked. These p... Read more
Reader Questions:
Check With Facility Before Choosing POS
Question: I'm new to billing for a physician who visits patients in nursing facilities. Wh... Read more
Reader Questions:
25 or 59 Depends on Distinguishing the Work
Question: Reporting modifiers with E/M service during a pulmonary function test (PFT) alwa... Read more
Reader Questions:
NPI Denials May Be From 1 Small Detail
Question: I applied for my NPI early, put it on my claims by the deadline, and added my le... Read more
You Be the Coder:
Billing Walk Test and E/M Service
Question: A patient completes a six-minute walk test in our office, then the pulmonologist... Read more
Combat Potential Payer Denials From E/M, Scope Sections
These tips will help stop 9921X and 31575 bundlingIf you find yourself fielding denials fo... Read more
Capture Asthma Education Using These 3 Codes
Use patient self-management codes or miss reimbursement opportunitiesWhen you report educa... Read more
Track Locum Tenens Billing Carefully or Face Audits
This is MD, not PA or CRNA, territoryA locum tenens physician may be temporarily added to ... Read more
Reader Questions:
V Code Vital for TB Test Claim
Question: When our physician's staff applies a purified protein derivative (PPD) tuberculo... Read more
Reader Questions:
Resort to Unlisted for Navigational Bronchoscopy
Question: Our physicians will soon begin performing navigational bronchoscopies. How shoul... Read more
Reader Questions:
Propellant-Driven Inhaler Falls Under 94664
Question: Should I use 94664 for education/training with the Advair diskus? Our allergist ... Read more
Reader Questions:
Column AA Shows if Assistant Is Allowed
Question: How do I find out if I can bill a procedure with an assistant surgeon? Washin... Read more
Reader Questions:
E/M Not Possible for Training-Only Session
Question: An established patient with chronic obstructive bronchitis reports to our office... Read more
You Be the Coder:
Know Your Timing Limits With PFTs
Question: Does Medicare establish limits on how many pulmonary function tests (PFTs) we ca... Read more
Accurately Document, Compile Critical Care Time Using This Guidance
CMS transmittal clears up family counseling, concurrent care rules To capture valuable... Read more
Use This FAQ to Nail Down NPP Critical Care Coding
Remember, Medicare rules prohibit split visit billing You'll have to follow specif... Read more
Protect Incident-to Pay With This Added Phrase
NPP can report service directly without having to satisfy CMS criteriaYour pulmonologist w... Read more
Reader Questions:
It's Not Too Late to Participate in PQRI
Question: Our pulmonology practice did not begin Physician Quality Reporting Initiative (P... Read more
Reader Questions:
Don't Code Built-in Service As Separate E/M
Question: A nurse practitioner (NP) sees a 65-year-old established patient for a pneumonia... Read more
Reader Questions:
Answer Preservative Question, Then Choose Code
Question: The pulmonologist's physician assistant (PA) performed a level-one E/M service f... Read more
Reader Questions:
New CCIs Bring Bronchoscopy Bundles
Question: A new correct coding initiative (CCI) is coming out soon, and I heard that bronc... Read more
You Be the Coder:
Put Your Consult Knowledge to the Test
Question: A patient's primary care physician (PCP) contacts our pulmonologist and asks him... Read more
Report Reinstated Inhalation Solution Codes to Prevent 'I' Denials
Surprise: Your albuterol, levalbuterol pay hinges on using HCPCS 2008 crossed-out codesYou... Read more
On the Cutting Edge:
Use 2 Questions to Pin Down J7611-J7614 Inhalation Coding
You can crosswalk brands, deleted code with this flowchartA year and a half has passed sin... Read more
Prepare for Tumor, Effusion, Pneumonia Diagnoses Switches
For specificity's sake, superbill must contain 209.xx, 511.8x and 997.3xIf you don't get y... Read more
Reader Questions:
Check Calendar Date When Coding Observations
Question: At 11 p.m. Thursday, the pulmonologist admits to observation an established pati... Read more
Reader Questions:
NPPs Should Note These Incident-to Updates
Question: There was recently some discussion on a professional coding listserv about a new... Read more
Reader Questions:
Count Lab Reviews Toward Total CPO Time
Question: The pulmonologist traveled 45 minutes to a team meeting as part of care plan ove... Read more
Reader Questions:
Remember Modifier When Lab Takes X-Rays
Question: The pulmonologist orders chest x-rays for a patient who goes to an outside labor... Read more
You Be the Coder:
Remember All Elements of Challenge Tests
Question: After a level-three new patient E/M, the pulmonologist orders a methacholine cha... Read more
Check for 2 Crucial Details to Land the Correct Thoracentesis Code
Clue: A catheter tells you therapeutic instead of diagnosticPatients who develop pleural e... Read more
Net 15 Percent More on Some E/Ms With Shared Visits
NPP, pulmonologist can team up for certain hospital servicesIn the office setting, inciden... Read more
CCI 14.1 Update:
Time Is of the Essence on Inhalation Codes
New bundles also affect ECG/apnea recording encountersNo fooling: The new Correct Coding I... Read more
Reader Questions:
Use More Specific Quit-Smoking Codes
Question: Sometimes we fret over the difficulty of getting paid for the numerous nonphysic... Read more
Reader Questions:
Type of Scope Drives Laryngoscopy Coding
Question: I am looking at a claim that shows the pulmonologist performed a laryngoscopy. N... Read more
Reader Questions:
Exceed Inherent E/M for Separate Code
Question: A nurse practitioner (NP) sees a 65-year-old established patient for a pneumonia... Read more
Reader Questions:
Freeze at 327.xx ICD-9 Section for Sleep Paralysis
Question: A new patient reports to the pulmonologist. He says that shortly after waking up... Read more
You Be the Coder:
Coding CPAP Initiation, Follow-Up Visits
Question: Our practice treats many patients with sleep apnea. We give out take-home contin... Read more
On the Cutting Edge:
Prove Patient's Asthmatic Status When Reporting Xolair
And don't forget to code for the supply, or you'll lose $$When the pulmonologist (or a sta... Read more
Coding Tool:
Look to Tree for Medical Necessity Knowledge
Is patient eligible for Xolair? These questions will help you find outWhen determining med... Read more
Give IVIG Code Set an Update to Avoid Rejections
If you haven't noticed the new HCPCS code changes for immune globulin injections yet, your... Read more
Reader Questions:
V Code Vital for TB Test Claim
Question: When the pulmonologist's staff applies a purified protein derivative (PPD) tuber... Read more
Reader Questions:
If Encounter Is for Training Only, E/M Not Possible
Question: An established patient with acute bronchitis reports to the pulmonologist's offi... Read more
Reader Questions:
Loop-E/M Encounter Results in 2 Codes
Question: If the pulmonologist performs flow volume loop and an E/M service, is the loop b... Read more
Reader Questions:
Review Apnea Codes Before Making Choice
Question: The pulmonologist performs a level-three E/M on a new patient. Notes indicate th... Read more
Reader Questions:
Zoom In on 'Targets' Before Coding Sedation
Question: An established 64-year-old patient reports to the pulmonologist for a scheduled ... Read more
Reader Questions:
You'll Code Differently for Blood Draws, Lab
Question: We saw a patient for a blood draw and sent it to an outside lab for testing. The... Read more
You Be the Coder:
'Nebulizer and Supply Bundles
Question: The pulmonologist's staff performs pressurized inhalation treatment with a nebul... Read more
Use These 4 Coding Do's to Protect Your Inhaler Pay
Also be on the lookout for a separately codeable education sessionStop missing opportuniti... Read more
Test Consultation Request With Simple Questions
Details on diagnosis, treatment light the way to consult or referral You've been on the... Read more
Expert Advice:
Navigate Transfer-of-Care Waters With This Guide
Form helps you show insurer the physician's consult actionsWhen a physician sends your pul... Read more
Reader Questions:
Choose Ventilator Management or E/M -- Not Both
Question: I have a tough coding choice to make. The pulmonologist performs initial-day ven... Read more
Reader Questions:
Reserve Modifier 21 for Highest-Level E/Ms
Question: I have two questions regarding modifier 21. Can we report it in the office setti... Read more
Reader Questions:
Consider Earlier Work When Choosing NF Code
Question: An established patient with acute pulmonary edema reports to the pulmonologist f... Read more
Reader Questions:
Payer Matters When Filing Flu Shot Claims
Question: A 58-year-old established patient reports to the pulmonologist for a flu shot. T... Read more
Reader Questions:
Physician Must Interpret Results for 94620
Question: The pulmonologist visits with a new patient complaining of wheezing and shortnes... Read more
You Be the Coder:
-- 'Multiple-Bronchoscopy Sessions
Question: An established patient with a cough reports to the pulmonologist complaining of ... Read more
Count Hours to Arrive at Proper Observation Code Choice
8-hour mark crucial for Medicare patientsWhen your pulmonologist performs observation serv... Read more
3 Steps for Correct Coding of Sleep Study, Polysomnography
Medicare requires studies to occur in 'approved sleep center'You can bolster your sleep te... Read more
Reader Questions:
Check POS to See if You Can Code NF Service
Question: The pulmonologist discharges a patient from the hospital and then admits him to ... Read more
Reader Questions:
Use System Reviews to Draw ROS Picture
Question: There are three review of systems (ROS) levels: problem-pertinent, extended and ... Read more
Reader Questions:
Remember New Thoracentesis Codes for 2008
Question: Our pulmonologist performed a level-four E/M on an established patient, resultin... Read more
Reader Questions:
Observe CCI Bundle on Spirometry, Volume Loop
Question: The pulmonologist sees an established patient who is complaining of breathing tr... Read more
Reader Questions:
Differentiate Between Different COPD Diagnoses
Question: Our physicians treat several patients with chronic obstructive pulmonary disease... Read more
You Be the Coder:
-- 'Making the Incident-to Decision
Question: An established Medicare patient who has a plan of care in place for her extrinsi... Read more
Time Makes the Difference on Multi-Substance Infusion Claims
Observe minimum infusion time on all codesWhen your pulmonologist infuses a patient with m... Read more
Prove Patient Is Critical Before Coding 99291
Remember to count bundled services toward critical care timeWhen the pulmonologist treats ... Read more
Clip and Save:
Chart Critical Care With This Checklist
Certain patient conditions could indicate 99291 serviceEstablishing critical illness or in... Read more
READER QUESTIONS:
Code Locum Tenens Service With Q6
Question: One of our pulmonologists is taking January off (an extended holiday). We have r... Read more
READER QUESTIONS:
Face-to-Face a Must on Medical Consult
Question: What is the best way to code for a family consult when the patient is not presen... Read more
READER QUESTIONS:
'Reliable' Settings Needed for Take-Home Oximeter
Question: Our pulmonologist sends a Medicare patient home with equipment so the patient ca... Read more
READER QUESTIONS:
1 Digit Makes Difference on Bronchitis Dx
Question: If the medical record indicates that a patient has chronic obstructive bronchiti... Read more
You Be the Coder:
Coding Your Physician's Hospital Claims
Question: The pulmonologist goes to the hospital to examine a new patient who has been cou... Read more
Look to Encounter Notes to Solve Vent Management Versus E/M Conundrum
Patient's status, therapy type lock down pay You can avoid losing over $100 for reporting... Read more
Stop Applying the 25-Percent Rule for Modifier 22
Rules are also tweaked for trio of  '50s modifiers' in CPT 2008 CPT 2008 makes the ... Read more
Recognize Incident-to or Your Bottom Line Will Suffer
Rule: If NPP treats a new problem, incident-to coding is impossible Each time one of your... Read more
Reader Questions:
Include Dx Codes for Lab Work
Question: When the pulmonologist collects blood samples and sends them to an outside lab ... Read more
Reader Questions:
You Can Charge for PPD Readings -- Sometimes
Question: We charge for a PPD placement but historically have not coded for reading the t... Read more
Reader Questions:
J7620 Makes Compound Drug Coding Easier
Question: Our nurse practitioner (NP) administered a nebulizer treatment recently, and I ... Read more
Reader Questions:
Separate Dates Key Multiple Bronchoscopy Coding
Question: The pulmonologist performs a level-four E/M for a new patient, then provides a ... Read more
Reader Questions:
Clear Up Filing Deadline Issues With Chart
Question: Our practice keeps getting denials because we are missing timely filing deadlin... Read more
You Be the Coder:
Multiple Spirometries and Methacholine Challenge Tests
Question: Our pulmonologist orders a methacholine challenge test on a patient at the loca... Read more
Available Years:  2008  2007  2006  2005  2004  2003  2002  2001  2000