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Pulmonology Coding Alert

CPT 2011:
Rejoice: You Can Report Home Sleep Studies Type III and IV with 95800, 95801
Check out this new bronchoscopy with balloon occlusion code. If you perform sleep studies... Read more
Pulmonary Stress Test:
94620, 94621 Take the Stress Out of Walk Test Coding
Ensure the presence of a physician when conducting these tests. If you find it hard to dif... Read more
Medicare Update:
90658: Ready To Bow Out in Favor of New Flu Vaccine HCPCS Codes
You have until December 31 to submit your 90658 claims. Beginning Jan. 1, you can forget a... Read more
Reader Questions:
G9141 For H1N1 Immunization Purposes
Question: I heard we can use G codes for Medicare H1N1 vaccination. What are they, and ho... Read more
Reader Questions:
493.9 Must Be a Clear Asthmatic Croup
Question: The physician diagnosed a six-month-old patient with croup. The mom describes t... Read more
Reader Questions:
86580 Without E/M For Your TB Test
Question: Should I code an office visit with PPD (TB test)? Answer: No. There is no actua... Read more
Reader Questions:
98961-98962, Not Synonymous With PR Educational Services
Question: We have recently started our pulmonary rehab department in our physician's clin... Read more
Reader Questions:
Support Your PSG Repeat Test With Documentation
Question: How often can I bill for polysomnography (95811) when the initial testing is in... Read more
You Be the Coder:
Avoid Submitting 95810 and 95811 Together
Question: My pulmonologist performed only the interpretation component of a split-night p... Read more
Vent Management Care:
94002-94003:3 Signals Point You to Encounter Note Gems
Higher level E/M pays more than vent management; don't lose out on the potential $221.When... Read more
Pulmonary Procedure:
94664: Have You Mastered the Do's and Don'ts of Inhaler Service Claims?
Inhaler demo could pay you $14 or more -- if you know how to navigate the rules.Three... Read more
Incident To:
Incident To: Cull Out Deserving Dollars Following 3 Guidelines
Physician's authorization of NPP's services is a rule you can't miss.The Centers for Medic... Read more
Reader Questions:
997.31 Makes Its Way to Respiratory Complications Coding
Question: A nursing home patient who has been dependent on ventilator was brought to the o... Read more
Reader Questions:
511.81 Links to 32422 for Malignant Pleural Effusion Care
Question: The pulmonologist visits with a patient with malignant cancer of the main bronch... Read more
Reader Questions:
PQRI 101: Can We Claim for Smoking Cessation?
Question: How can our practice benefit from Physician Quality Reporting Initiative's (PQRI... Read more
Reader Questions:
99406 Guarantees Cessation Counseling Pay
Question: The pulmonologist-referred preventive care physician spent 10 minutes counseling... Read more
Reader Questions:
780.51 Isn't Complete for Sleep Apnea Service
Question: The pulmonologist performs a level-three E/M on a patient with sleep issues. The... Read more
Reader Questions:
415.x or 401.x: Decide Between Essential and Pulmonary Hypertension
Question: Should I report both essential hypertension and pulmonary hypertension together?... Read more
Reader Questions:
32421-32422 and 32551 Translate to Pleural Effusion Treatment
Question: I'm not sure I know what a pleural effusion is. How does the physician treat it?... Read more
You Be the Coder:
94005 Answers Your Home Vent Service Dilemma
Question: How do I code home ventilator management?Nebraska SubscriberAnswer: You would re... Read more
CCI Edits:
CCI 16.3 Highlights Pulmonary Rehab with Mutually and NME Edits
Uncover which of the 150 NMEs won't unbundle with any modifier.If you commonly report pulm... Read more
ICD-9:
493.2x Can Be Confusing Without the Right Documentation
When does status asthmaticus supercede COPD? Find out. Your physician's notes may ... Read more
News You Can Use:
G Codes Offer Smooth Transition to CMS Final Rule
Support your PR program with diagnosis of moderate to severe COPD.The passing of CMS' fina... Read more
Reader Questions:
94640 + J Code: Go Full Circle with Albuterol Treatment
Question: My pulmonologist performed an albuterol treatment in the office. Can I bill for ... Read more
Reader Questions:
99221-99223 Rules Out Your Consultation Codes Options
Question: A patient presented in the office for asthma exacerbation, but got admitted the ... Read more
Reader Questions:
31620: Code EBUS Freely with Bronchoscopy Procedures
Question: A patient undergoes a routine bronchoscopy. When the pulmonologist discovers a v... Read more
Reader Questions:
94660 Resolves Your Ventilation Dilemma
Question: The pulmonologist sees a hospital inpatient suffering from pulmolithiasis. The n... Read more
Reader Questions:
99214: Take into Account Discussion with Patient
Question: As a pulmonologist and sleep specialist, I spend a lot of time discussing manage... Read more
Reader Questions:
20552: 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:
90656 and 90658 Are Handy When Reporting Flu Vaccine Supply
Question: How should I report flu vaccine supply? Hawaii SubscriberAnswer: You'd have to c... Read more
You Be the Coder:
31623, 31624 and 31628 Secure Your Multiple Bronchoscopy Coding
Question: If I used the bronchoscopy codes 31628, 31623, and 31624 together in a claim, wo... Read more
Ventilation Study Coding:
Highlight This Give-Away Lingo for Proper V/Q Test Coding
Distinguish perfusion scans by reading between the lines. Here's how. Coding perfusion an... Read more
Coding Scenario:
Equip Yourself with Solid Spirometry Coding Options
Find out why E/M + modifier 25 is not a solid equation. When you're coding for spirometry... Read more
ICD-9:
Let Time Define Your Pulmonary Embolism Coding
Acute or chronic? Count the ways! Facing the task of reporting pulmonary embolism can be ... Read more
Reader Questions:
Shedding Light on Hospital Care Coding
Question: My pulmonologist writes a short admit note with a problemfocused history of pre... Read more
Reader Questions:
Differentiate Between PPD TB Test and Vaccination
Question: The staff in my office applies a purified protein derivative (PPD) tuberculosis... Read more
Reader Questions:
Look for Causes Before Coding Sleep Apnea
Question: What ICD-9 code should I report when the pulmonologist performs a level-two E/M... Read more
Reader Questions:
Don't Equate New Physician with New Patient
Question: We have a new pulmonologist in our group whose patients from his previous group... Read more
Reader Questions:
Work Your Way Through Different Types of Asthma
Question: What is the ICD-9 code for mild, intermittent asthma? New Hampshire Subscriber ... Read more
You Be the Coder:
Manage Your 94660 Coding Carefully
Question: We are billing a recurring office visit code (99211\"99215) with 94660 on the s... Read more
Sleep Study:
3 Tips Accelerate Your Actigraphy Coding Claims
Leaving off this key modifier could mean a disaster.Last year, you saw the introduction of... Read more
ICD-9 Coding:
Heed These 3 Essential Warnings When Using E-Codes
Find out how E codes help insurance companies on injury prevention and safety issues.If yo... Read more
Modifiers:
Test Yourself with Real-Life Modifier 25 Scenarios
Do you have the same coding conclusions as our experts?As you may already know, you have t... Read more
Check Out This Pulmonolgy-Specific Modifier 25 Example
Your pulmonologist sees Mrs. Jones in the office and gives her a nebulizer treatment in th... Read more
Reader Questions:
Conditions Bind Billing E/M, Procedure on the Same Day
Question:Can you, at any time during an outpatient bronchoscopy, bill an E/M outside of a ... Read more
Reader Questions:
Avoid 2 Pulmonologist Reporting Same-Day Critical Care
Question:A pulmonologist in our practice saw a patient in the morning for critical care. I... Read more
Reader Questions:
Include As Many Bronchoscopy Codes -- If Necessary
Question:Codes 31628, 31624, and 31624 are all for bronchoscopy procedures. Will payers de... Read more
Reader Questions:
Follow PQRI Rules to the Letter
Question:Does e-prescribing require entry of all of a patient's medications into an electr... Read more
Reader Questions:
Focus on Single Diagnosis During E/M Encounter
Question:My pulmonologist sees an established patient who complains of trouble in breathin... Read more
Reader Questions:
When Does Moderate Sedation Fit?
Question:The pulmonologist performs a scheduled flexible bronchoscopy on an established 64... Read more
Reader Question:
Make COPD Diagnosis Codes Work to Your Advantage
Question:My pulmonologist documents both COPD and acute bronchitis for a patient who prese... Read more
You Be the Coder:
Don't Confuse 96401 with 96372 for Xolair Administration
Question:We just gave our first Xolair injection recently. The patient had the drug shippe... Read more
Surgery Coding:
Avoid Making Critical Mistakes When Coding Lung Volume Reduction Surgeries
Code 32491's descriptor eliminates the need to ever use modifiers 50, 52.Billing for lung ... Read more
Mythbuster:
What Don't You Know About Thoracoscopy Coding Could Hurt Your Claims
Diagnostic scopes do not always translate to 32601. Find out why.Whether it's internally i... Read more
News You Can Use:
Category III Codes: Keep Pace With Emerging Technologies
New codes on PFT, wheeze rating, and bronchial valve take the stage in 2011.Brace yourself... Read more
Reader Questions:
Employ CPT Where It Is Helpful
Question: I heard that most pulmonologists do not allow the use of cardiopulmonary therapy... Read more
Reader Questions:
Charge E/M by Therapist, But Not Separately
Question: A respiratory therapist in our practice provided E/M to a patient. Can we bill f... Read more
Reader Questions:
Shoot for 94249 to Determine Lung Volume, Capacity
Question: What is the CPT for lung volumes by nitrogen wash out? Tell me more about how it... Read more
Reader Questions:
Give Albuterol Treatment a Go With 94660
Question: Please help me with the coding of a nebulizer packet and abuterol treatment that... Read more
Reader Questions:
Avoid Hitting a Dead End on BAL
Question: My physician is performing bronchial alveolar lavage (BAL) and biopsy through th... Read more
Reader Questions:
Clarify Temp Services Using Modifier Q6
Question: Our regular pulmonologist is taking some time off, and a temporary pulmonologist... Read more
Reader Questions:
Don't Leave Out Modifier 59 For Separate Spirometry
Question: An elder patient who walked several blocks to our practice presented with dyspne... Read more
You Be the Coder:
CMS Pays for Echocardiography on Various Diagnoses
Question: I often have to bill 93306 for pulmonologists in our practice. What are the paya... Read more
Case Study:
Bronchoscopy + Thoracotomy: Look For This Exception to the CCI Rule
Don't even think about appending modifier 51 to 38746 -- here's why.Rarely do broncho... Read more
Coding Quiz:
2 Factors Make a Difference in Thoracentesis Coding
Misunderstanding physician's notes can cost your practice $38 per procedure.Don't shortcha... Read more
Guidelines:
Apply 3 Add-On Code Tips To Ensure Payable Claims
Never leave "add-ons" hanging without a primary procedure.Like it or not, "add-on" (ZZZ) c... Read more
Coding Quiz Answers:
Draw the Line Between 32421 and 32422 Using Physician Notes as a Tool
Tip: Syringe and catheter play important roles.Thoracentesis helps to diagnose or to treat... Read more
Reader questions:
Use 31502 for Unestablished Trachestomy Track
Question: If a pulmonologist performs a trach change, should I report 31502? How about app... Read more
Reader questions:
Understand Issues Surrounding 76000
Question: Our pulmonologist performs a fluoroscopic "sniff" test for evaluation of the dia... Read more
Reader questions :
Align 94667 with Mandatory Hands-On Therapy
Question: Can I use 94667 and 94668 for showing a patient how to use a flutter valve? In o... Read more
You be the coder:
Peek Into Thoracentesis with Imaging-Capable Ultrasound
Question: My pulmonologist uses ultrasound to assess the presence and size of a pleural ef... Read more
Mythbuster:
Is Your Sleep Study Unattended? The Answer Could Cost You.
The patient may or may not be awake when you report 95805 -- find out why.Coding slee... Read more
Coding Quiz; Coding Quiz:
Examine 3 Scenarios to Lock Down Ventilator Management
Careful: You should always bundle ventilator management codes with E/M.Keep your encounter... Read more
Modifier Guidelines:
Master Your Pulmonology Modifier 59 Use with 4 Guidelines
Make sure you adhere to the correct criteria or suffer being 'red flagged.'A modifier in t... Read more
Ventilator Management Solutions:
Coding Quiz Answers: Inch Your Way into Proper Ventilator Management Coding
Tip: Present providers with better-paying codes.All the mix and match of coding ventilator... Read more
Reader Questions:
Don't Lump Colds and Flu into One Test Option
Question: A patient presents with acute sinusitis and an upper respiratory infection that ... Read more
Reader Questions:
Skip Unspecified Asthma Code
Question: My allergist's notes state, "A history of asthma-induced bronchitis." Does this ... Read more
You Be the Coder:
Check Asthma Before Coding for WARI
Question: I'm confused about acute bronchospasm (519.11). I heard you can simply bill 786.... Read more
Perfect Your Pulse Oximetry Claims by Asking 3 Questions
Don't let the almost $30 payment for technical services slip out of your pocket. Think co... Read more
3 Hints Untangle Your Cystic 3 Hints Untangle Your Cystic
Patient has pneumonia, too? Use a diagnosis code that extends to the fifth digit. If you'... Read more
How Much ROS Documentation Is Enough?
Caution: Keep enough paperwork on hand to back up EHR. Transitioning to the world of Elec... Read more
Reader Questions:
Collect Your Payment When You Discharge a Patient
Question: Who can bill the 99238 discharge on a Medicare patient? Does it have to be the ... Read more
Reader Questions:
Check CCI Edits for Office Visit
Question: A payer denied our claim for an established patient office visit in addition to... Read more
Reader Questions:
Get Paid for 94760 Based on Its Physician Fee Schedule Status
Question: My practice has just started to bill pulmonary function tests (PFTs). In one ca... Read more
Reader Questions:
Distinguish Routine Cell Washings from BAL Washings
Question: A pulmonologist performed electrocautery resection of endobronchial tumor, had ... Read more
Reader Questions:
Unclog Confusion When Coding Bronchitis
Question: If the doctor says "acute exacerbation of chronic bronchitis," wouldn't it be b... Read more
You Be the Coder:
Opt for Standard Bronchoscopy When Performed via ETT
Question: My pulmonologist performed a bronchoscopy on a burn victim through an endotrach... Read more
Billing Tracheostomy Tube Changes? 5 Pitfalls Help You Prevent Errors
Examine your place of service before submitting 31899 and A4629.Coding a tracheostomy tube... Read more
Authoritative:
5 Pulmonary Rehabilitation Tips Bring You Up-to-Date with New PR Coverage
Learn why you need to strike the 97000 series off your list.As of Jan. 1, legislation for ... Read more
Beware:
Don't Use Consultation Codes for Medicare in 2010
Find out how much CMS has raised payment for other E/M codes.The inevitable has happened&n... Read more
News You Can Use:
Feds Save Your Conversion Factor Rate -- For Now
Also: Here's why you shouldn't freak out if your MAC payments are a bit late.Remember that... Read more
Reader Questions:
Look Away from Coding Generalized Bronchitis
Question: I used 491.9 to report a patient's bronchitis, but the payer denied my claim and... Read more
Reader Questions:
Forget About Coding for Home Therapy
Question: A pulmonologist orders home chest physiotherapy (CPT) by a respiratory therapis... Read more
You Be the Coder:
Turn to 94799 for HeO2 Administration
Question: What is the code for the administration of Heliox therapy to a patient in the IC... Read more
Breathe Easy Submitting Your Pulmonary Stress Test Claims by Highlighting These 94620, 94621 Differences
Find out what blood-draw and analysis codes you can report separately. Pulmonary stress t... Read more
Coding Quiz:
Take This PST and Spirometry Challenge
Deal with a patient's dyspnea on and off exercise. Not sure if you've absorbed the pulmon... Read more
Set the Record Straight:
Diagnosis Code Options for COPD
What your pulmonologist writes in the documentation matters. The pulmonologist's document... Read more
Coding Quiz Answer:
Adhere to PST Medical Necessity
Declare your spirometry code distinct. Did you use modifier 59 (Distinct procedural servi... Read more
Save Time by Managing the Generic Supply Code 99070
Improve supply payback with 5 requirements. You might think that you can use 99070 as a c... Read more
READER QUESTIONS:
Lay Out the Right Bronchoscopy Code for 31600
Question: What code should I report for a bronchoscopy if the pulmonologist was scheduled... Read more
READER QUESTIONS:
Separate Sleep Study From Your H&P Coding
Question: If a nurse practitioner (NP) performed an H&P (history and physical ex... Read more
READER QUESTIONS:
Modifier TC Makes or Breaks Your PFT Reporting
Question: I've heard that a pulmonary function test (PFT) needs to have a physician inter... Read more
READER QUESTIONS:
Nurse Code Calls for Face-to-Face Encounter
Question: A pulmonologist reviews lab test results and orders additional testing and medi... Read more
READER QUESTIONS:
Look for Sequential Skin Testing on 95024 Vs. 95027
Question: What is the difference between 95024 and 95027 to use for reporting skin testin... Read more
You Be the Coder :
Don't Miss Out on Fifth Digit Asthma Diagnosis
Question: Do I need a fifth digit when reporting 493.xx (Asthma)? Michigan Subscriber Ans... Read more
5 Telltale Signs Mark the Way to Hassle-Free Septic Embolism Reporting
Pick out the right diagnosis based on the disease's origin. Still feeling your way into t... Read more
You Be the Code:
Avoid Complications of ENB Billing With 31627
Question: A patient presents to the pulmonologist for possible lung cancer. The pulmonolo... Read more
Hail to the Chief -- Complaint
Chief complaint need not be at the very top of the note, but the physician must state it ... Read more
Coding Quiz:
Try Your Hand at This Diagnostic Bronchoscopy Challenge
31622's everyday function may surprise you. If you're fuzzy on bronchoscopy coding basics... Read more
Coding Quiz Answers:
Get Through Diagnostic Bronchoscopy Coding Without Hassles
Stick with the basics if you'd like a squeaky clean claim. What do you have to say from t... Read more
READER QUESTIONS:
Rest Home Visit vs. CPO
Question: A physician evaluates a new patient in an assisted living facility for hyperten... Read more
READER QUESTIONS:
Critical Care Doesn't Always Mean Hospital
Question: My physician documented that he performed critical care services for a patient ... Read more
READER QUESTIONS:
Watch Carrier Rules for 94760 + E/M
Question: Can I get paid by Medicare carriers for 94760 with any E/M code? Maine Subscrib... Read more
READER QUESTIONS:
Use 'Specialist Opinion' Code for Non-Physician Referrals
Question: What is the appropriate E/M code for a pulmonary consultation with pre- and pos... Read more
READER QUESTIONS:
Confused About TB Skin Test? Look at a Patient's Symptoms
Question: I'm not sure which diagnosis code to use with 86580 when billing for a PPD on a... Read more
READER QUESTIONS:
Look to Distinction for Modifiers 25, 59
Question: When appending modifiers with E/M service during a pulmonary function test (PFT... Read more
READER QUESTIONS:
Shoot for Unlisted Procedure in MIPs, MEPs
Question: What code applies for MIP (maximal inspiratory pressure) and MEP (maximal expir... Read more
READER QUESTIONS:
Qualify Pulmonary Quantitative Study Separately From PFT
Question: When do I use 78596 for complete PFT? Washington Subscriber Answer: Code 78596 ... Read more
READER QUESTIONS:
Give Nebulizer Use Fair Treatment With J Code Inclusion
Question: I have no idea how to report albuterol treatment in an office. Is the procedure... Read more
Available Years:  2010  2009  2008  2007  2006  2005  2004  2003  2002  2001  2000