Pulmonology Coding Alert
Procedure Coding:
3 Answers Unlock Cystic Fibrosis Diagnosis and Treatment Coding Secrets
Patient has pneumonia, too? Use a diagnosis code that extends to the last digit. You ... Read more
3 Answers Unlock Cystic Fibrosis Diagnosis and Treatment Coding Secrets
Patient has pneumonia, too? Use a diagnosis code that extends to the last digit. You ... Read more
Diagnosis Corner:
Clear Up Your COPD Complication Coding Confusion With This Advice
Focus on acute conditions and precedence rules to select the right code Your correct i... Read more
Clear Up Your COPD Complication Coding Confusion With This Advice
Focus on acute conditions and precedence rules to select the right code Your correct i... Read more
Payer Rules:
Get ABNs to Avoid Later Blushes on Rejection of Uncovered Services
ABN protocols may even benefit your patient relations. While you may face resistance f... Read more
Get ABNs to Avoid Later Blushes on Rejection of Uncovered Services
ABN protocols may even benefit your patient relations. While you may face resistance f... Read more
ICD-10 Implementation:
Continued Training is the New Watchword After ICD-10 Adoption
Incorporating coders’ inputs is crucial in the expanded diagnosis scenarios. Alt... Read more
Continued Training is the New Watchword After ICD-10 Adoption
Incorporating coders’ inputs is crucial in the expanded diagnosis scenarios. Alt... Read more
Readers Question:
Talk to Your Payer Before Billing Phone Consults
Question: Another office just informed us about getting paid from their contractor for t... Read more
Talk to Your Payer Before Billing Phone Consults
Question: Another office just informed us about getting paid from their contractor for t... Read more
You Be the Coder:
Don't Use Bronchial Valve Codes for Bronchial Blocker Placement
Question: Our pulmonologist evaluated a patient recently for persistent air leak. The pa... Read more
Don't Use Bronchial Valve Codes for Bronchial Blocker Placement
Question: Our pulmonologist evaluated a patient recently for persistent air leak. The pa... Read more
CPT® 2016:
New EBUS Codes Lead These Pulmonology Code Additions, Revisions, and Deletions
You also need to strike these four codes from your manual, or you’ll face denials.... Read more
New EBUS Codes Lead These Pulmonology Code Additions, Revisions, and Deletions
You also need to strike these four codes from your manual, or you’ll face denials.... Read more
CPT® 2016:
Get Ready to Welcome New and Revised Prolonged Services Codes Next Year
Revised codes can be added on to any service level, not just the highest. Change has ... Read more
Get Ready to Welcome New and Revised Prolonged Services Codes Next Year
Revised codes can be added on to any service level, not just the highest. Change has ... Read more
Flu Coding:
Incorporate Modifier 59 When Testing For 2 Flu Strains
Hint: Submitting code 87804 x 2 is a strict no no. Despite the medical community&rsquo... Read more
Incorporate Modifier 59 When Testing For 2 Flu Strains
Hint: Submitting code 87804 x 2 is a strict no no. Despite the medical community&rsquo... Read more
Readers Question:
CPAP or E/M: Choose Wisely to Save Those Precious Dollars
Question: A patient had a sleep study done and came to our office afterwards for an... Read more
CPAP or E/M: Choose Wisely to Save Those Precious Dollars
Question: A patient had a sleep study done and came to our office afterwards for an... Read more
Reader Question:
Look At 31622 As Last Option While Reporting Lavage
Question: Bronchoscopy dictation states, “copious amounts of mucopurulent, br... Read more
Look At 31622 As Last Option While Reporting Lavage
Question: Bronchoscopy dictation states, “copious amounts of mucopurulent, br... Read more
Reader Question:
Distinguish Between Insect Venom and Other Antigens Before Coding Injections
Question: We are having problems getting reimbursed for allergy injections for stin... Read more
Distinguish Between Insect Venom and Other Antigens Before Coding Injections
Question: We are having problems getting reimbursed for allergy injections for stin... Read more
Reader Question:
Steer Clear of Reporting Two Observation Codes On Same Day
Question: Occasionally we place a patient in observation status for one to three da... Read more
Steer Clear of Reporting Two Observation Codes On Same Day
Question: Occasionally we place a patient in observation status for one to three da... Read more
You Be the Coder:
Use Consultation Codes For Discussing Patient Care With Family
Question: Can we bill code 90846 for our pulmonologist when she is meeting with fam... Read more
Use Consultation Codes For Discussing Patient Care With Family
Question: Can we bill code 90846 for our pulmonologist when she is meeting with fam... Read more
Sleep Studies:
Distinguish the Difference Between Sleep Studies and Polysomnography With These 3 Tips
Focus on 3 factors to reach the best coding option. Increased lev... Read more
Distinguish the Difference Between Sleep Studies and Polysomnography With These 3 Tips
Focus on 3 factors to reach the best coding option. Increased lev... Read more
News You Can Use:
OIG Report May Lead to More Sleep Study Refunds to MACs
Clear documentation of the patient’s progress may keep you in the clear. Your ma... Read more
OIG Report May Lead to More Sleep Study Refunds to MACs
Clear documentation of the patient’s progress may keep you in the clear. Your ma... Read more
E/M Corner:
Back Up Your Level of E/M Services With Medical Necessity
Key: MDM and medical necessity are not the same. If you are reporting high level E/M c... Read more
Back Up Your Level of E/M Services With Medical Necessity
Key: MDM and medical necessity are not the same. If you are reporting high level E/M c... Read more
Readers Question:
Don't Miss Instructional ICD-10 Notes
Question: My doctor saw a male Medicare patient with a 3-day history of cough, whee... Read more
Don't Miss Instructional ICD-10 Notes
Question: My doctor saw a male Medicare patient with a 3-day history of cough, whee... Read more
Reader Question:
Look at Type of Test Before Reporting Perfusion Imaging
Question: Our pulmonologist was called in to perform a perfusion imaging with aeros... Read more
Look at Type of Test Before Reporting Perfusion Imaging
Question: Our pulmonologist was called in to perform a perfusion imaging with aeros... Read more
You Be the Coder:
Asthma Education May Qualify for Prolonged Services
Question: A new patient visited our office with breathing problems. The physician t... Read more
Asthma Education May Qualify for Prolonged Services
Question: A new patient visited our office with breathing problems. The physician t... Read more
Injection Services:
Banish All Xolair Coding Blues With These Expert Tips
Make double sure with your LCD before coding 96401. If you dread choosing the right co... Read more
Banish All Xolair Coding Blues With These Expert Tips
Make double sure with your LCD before coding 96401. If you dread choosing the right co... Read more
E/M Corner:
Tick All Time Checks Before Choosing Observation Codes
Multi-day stays means separate discharge codes. You may encounter many bumps on the ro... Read more
Tick All Time Checks Before Choosing Observation Codes
Multi-day stays means separate discharge codes. You may encounter many bumps on the ro... Read more
ICD-10 News:
CMS Releases ICD-10 Clarifications for a Smoother Transition
Even getting the “family of codes” right will be enough. The Centers for M... Read more
CMS Releases ICD-10 Clarifications for a Smoother Transition
Even getting the “family of codes” right will be enough. The Centers for M... Read more
Reader Question:
Get the Modifiers and Exclusion Right Before Coding for Plethysmography
Question: We have started performing plethysmography tests recently. However, the insura... Read more
Get the Modifiers and Exclusion Right Before Coding for Plethysmography
Question: We have started performing plethysmography tests recently. However, the insura... Read more
Reader Question:
Same-Day Admission Takes Precedence Over Office E/M
Question: Our physician saw a patient in the office, then admitted her to the hospital. ... Read more
Same-Day Admission Takes Precedence Over Office E/M
Question: Our physician saw a patient in the office, then admitted her to the hospital. ... Read more
You Be the Coder:
Don't Expect Reimbursement for DME Used During Inhalation Therapy
Question: Our physician administered drug inhalation (Albuterol in unit dose). How... Read more
Don't Expect Reimbursement for DME Used During Inhalation Therapy
Question: Our physician administered drug inhalation (Albuterol in unit dose). How... Read more
Case Studies:
Recoup the Right Reimbursement by Following These 3 PFT Focused Cases
Bill 94010 and 94060 together at your own peril. Dealing with pulmonary function test ... Read more
Recoup the Right Reimbursement by Following These 3 PFT Focused Cases
Bill 94010 and 94060 together at your own peril. Dealing with pulmonary function test ... Read more
Modifier Mashup:
Make Modifier 22 Pay You For That Extra Physician Work
Demonstrate the unusual nature of the procedure and ask for payment You can stand to a... Read more
Make Modifier 22 Pay You For That Extra Physician Work
Demonstrate the unusual nature of the procedure and ask for payment You can stand to a... Read more
Compliance Alert:
Provide Proper POS Line Items to Avoid MAC Ire
CMS looks at over $33 million overpayment due to place of service errors. The OIG&rsqu... Read more
Provide Proper POS Line Items to Avoid MAC Ire
CMS looks at over $33 million overpayment due to place of service errors. The OIG&rsqu... Read more
Readers Questions:
Check Biopsy Bundlings Before Billing With Bronchoscopy
Question: Recently our pulmonologist performed a bronchoscopy with left-upper lobe ... Read more
Check Biopsy Bundlings Before Billing With Bronchoscopy
Question: Recently our pulmonologist performed a bronchoscopy with left-upper lobe ... Read more
Readers Questions:
Ditch Redundant Diagnostic Codes for Spirometry Testing
Question: A new patient reports to the pulmonolgist complaining of shortness of bre... Read more
Ditch Redundant Diagnostic Codes for Spirometry Testing
Question: A new patient reports to the pulmonolgist complaining of shortness of bre... Read more
Readers Questions:
Specific Diagnostic Codes Help You Bill Insulin Inhalation Testing
Question: A patient recently visited us and enquired about the mandated spirometry ... Read more
Specific Diagnostic Codes Help You Bill Insulin Inhalation Testing
Question: A patient recently visited us and enquired about the mandated spirometry ... Read more
You Be the Coder:
Check Local Policies Before Reporting Pleural Biopsy With Drainage
Question: Our physician recently treated a patient who had a pleural effusion. The ... Read more
Check Local Policies Before Reporting Pleural Biopsy With Drainage
Question: Our physician recently treated a patient who had a pleural effusion. The ... Read more
Diagnosis Coding:
Secure Your Spirometry Payment With 3 Diagnostic Coding Tips
Double check the “medically necessary” codes allowed by your payer. Spirom... Read more
Secure Your Spirometry Payment With 3 Diagnostic Coding Tips
Double check the “medically necessary” codes allowed by your payer. Spirom... Read more
Modifier Update:
CMS Agrees New Modifiers X(EPSU) Offer 'No Benefit' For Now
You may keep using 59 until further notice. Many practices have been getting busy or g... Read more
CMS Agrees New Modifiers X(EPSU) Offer 'No Benefit' For Now
You may keep using 59 until further notice. Many practices have been getting busy or g... Read more
ICD-10 News:
Enjoy Extended Coverage as New Bill Proposes Transition Period
HHS to prove readiness and provide 18 months cover from denials. Get ready for the lat... Read more
Enjoy Extended Coverage as New Bill Proposes Transition Period
HHS to prove readiness and provide 18 months cover from denials. Get ready for the lat... Read more
Reader Questions:
Check Administration and Provision for Allergen Immunotherapy Billing
Question: Our office has decided to provide allergy injections (different medicatio... Read more
Check Administration and Provision for Allergen Immunotherapy Billing
Question: Our office has decided to provide allergy injections (different medicatio... Read more
Reader Questions:
Check Duration of Treatment for Reporting Inhalation Therapies
Question: Our office provides inhalation therapies. Which codes specifically apply ... Read more
Check Duration of Treatment for Reporting Inhalation Therapies
Question: Our office provides inhalation therapies. Which codes specifically apply ... Read more
Reader Questions:
Let Type of Test Guide Your Ventilation/Perfusion Imaging Codes
Question: Our physician performed pulmonary ventilation/perfusion imaging with aero... Read more
Let Type of Test Guide Your Ventilation/Perfusion Imaging Codes
Question: Our physician performed pulmonary ventilation/perfusion imaging with aero... Read more
You Be the Coder:
Check for Key Components Before Claiming Nursing Home Consultation
Question: Our physician went to the nursing home to see a Medicare patient for cons... Read more
Check for Key Components Before Claiming Nursing Home Consultation
Question: Our physician went to the nursing home to see a Medicare patient for cons... Read more
Polysomnography Coding:
Optimize Reimbursement for Split Study With These Pointers
Watch date of service for reporting bundled codes such as 95811. Patients suffering fr... Read more
Optimize Reimbursement for Split Study With These Pointers
Watch date of service for reporting bundled codes such as 95811. Patients suffering fr... Read more
ICD-10 Prep:
Get a Realistic Estimate of Your Transition Preparedness With Test Preps
Avail of Medicare’s end-to-end testing opportunity for a hands-on experience. Do... Read more
Get a Realistic Estimate of Your Transition Preparedness With Test Preps
Avail of Medicare’s end-to-end testing opportunity for a hands-on experience. Do... Read more
ICD-10 Update:
Prepare For an Expanded COPD Code Group With a Focus On Complications
Four of the seven COPD base code descriptors for ICD-9 are direct matches to ICD-10. I... Read more
Prepare For an Expanded COPD Code Group With a Focus On Complications
Four of the seven COPD base code descriptors for ICD-9 are direct matches to ICD-10. I... Read more
Compliance Alert:
Blow Up These Common Compliance Myths for Coding Success
Pay heed to this advice -- or rue missed chances on rejected claims. You may be paying... Read more
Blow Up These Common Compliance Myths for Coding Success
Pay heed to this advice -- or rue missed chances on rejected claims. You may be paying... Read more
Readers Queries:
Take Care of Modifiers While Interpreting Radiological Tests
Question: Our pulmonologist was recently called upon to analyze chest x-ray images ... Read more
Take Care of Modifiers While Interpreting Radiological Tests
Question: Our pulmonologist was recently called upon to analyze chest x-ray images ... Read more
Readers Queries:
Back Up Your Unusual Procedural Services Claim With Watertight Notes
Question: Our pulmonologist recently performed a bronchoscopy with BAL on a morbidl... Read more
Back Up Your Unusual Procedural Services Claim With Watertight Notes
Question: Our pulmonologist recently performed a bronchoscopy with BAL on a morbidl... Read more
Readers Queries:
Pick Your J Codes Carefully for Reporting Albuterol Inhalation
Question: Our office has received enquiries for administration of Albuterol/levalbu... Read more
Pick Your J Codes Carefully for Reporting Albuterol Inhalation
Question: Our office has received enquiries for administration of Albuterol/levalbu... Read more
You Be the Coder:
Factor In the Dates While Reporting Multiple Bronchoscopies
Question: An established patient visited our pulmonologist at the office for shortn... Read more
Factor In the Dates While Reporting Multiple Bronchoscopies
Question: An established patient visited our pulmonologist at the office for shortn... Read more
Physician Services:
Inject New Life Into Your Inhaler Service Claims by Answering 3 Questions
Judicious use of modifiers 25 and 59 will pay you more -- if you know how to navigate th... Read more
Inject New Life Into Your Inhaler Service Claims by Answering 3 Questions
Judicious use of modifiers 25 and 59 will pay you more -- if you know how to navigate th... Read more
E/M Components:
Choose Wisely Between 99213, 99214 to Collect Deserved Cash
Go through documentation with a keen eye to decide the levels of outpatient visit. Eve... Read more
Choose Wisely Between 99213, 99214 to Collect Deserved Cash
Go through documentation with a keen eye to decide the levels of outpatient visit. Eve... Read more
Influenza Testing:
Safeguard Your Second-Strain Flu Testing Payment With These Tips
Ask your payer before appending modifier QW to 87804. You have to determine whether yo... Read more
Safeguard Your Second-Strain Flu Testing Payment With These Tips
Ask your payer before appending modifier QW to 87804. You have to determine whether yo... Read more
ICD-10 Update:
Get Ready for More Specificity in Reporting Emphysema
The fourth digit opens a new world of complications. If your pulmonology practice give... Read more
Get Ready for More Specificity in Reporting Emphysema
The fourth digit opens a new world of complications. If your pulmonology practice give... Read more
Reader Questions:
Billing Separate E/M for Same Group Physicians is a Strict No-No
Question: Two pulmonologists in our practice treated a patient twice on the same da... Read more
Billing Separate E/M for Same Group Physicians is a Strict No-No
Question: Two pulmonologists in our practice treated a patient twice on the same da... Read more
You Be the Coder:
Tread Carefully While Reporting Histamine Challenge Test and Supply
Question: Our pulmonologist recently administered a histamine challenge test? She a... Read more
Tread Carefully While Reporting Histamine Challenge Test and Supply
Question: Our pulmonologist recently administered a histamine challenge test? She a... Read more
Diagnosis Coding:
Hike Up Your Histoplasmosis Coding Pay With These Tips
Overlooking symptoms could set you back by $172. Reporting the diagnosis of histoplasm... Read more
Hike Up Your Histoplasmosis Coding Pay With These Tips
Overlooking symptoms could set you back by $172. Reporting the diagnosis of histoplasm... Read more
Consult Services:
Consolidate Your Inpatient Consult Coding With These 5 Tips
You can bill initial visits again on re-admission of a discharged patient. When your p... Read more
Consolidate Your Inpatient Consult Coding With These 5 Tips
You can bill initial visits again on re-admission of a discharged patient. When your p... Read more
Counseling Sessions:
Secure Your Smoking Cessation Payment With These 3 Scenarios
G0436 or G0437 are the codes of choice while making your decision. You may think that ... Read more
Secure Your Smoking Cessation Payment With These 3 Scenarios
G0436 or G0437 are the codes of choice while making your decision. You may think that ... Read more
Readers Questions:
Prioritize the Primary Diagnosis Codes in AERD Cases
Question: Our pulmonologist recently evaluated an established patient in the office... Read more
Prioritize the Primary Diagnosis Codes in AERD Cases
Question: Our pulmonologist recently evaluated an established patient in the office... Read more
You Be the Coder:
Press the Pause Button Before Billing Oximtery and E/M Together
Question: We are billing an evaluation and management (E/M) code 99212 alo... Read more
Press the Pause Button Before Billing Oximtery and E/M Together
Question: We are billing an evaluation and management (E/M) code 99212 alo... Read more
Critical Care:
Answer 4 Questions to Crank Up Your Critical Care Payouts
Don’t give up deserved payment for unbundled services along with critical care. ... Read more
Answer 4 Questions to Crank Up Your Critical Care Payouts
Don’t give up deserved payment for unbundled services along with critical care. ... Read more
Modifier Alert:
Distinguish Between Modifiers 52 and 53 to Avoid Denials
Voluntary termination of procedure by the patient does not count. When your pulmonolog... Read more
Distinguish Between Modifiers 52 and 53 to Avoid Denials
Voluntary termination of procedure by the patient does not count. When your pulmonolog... Read more
Consultation Coding:
Capture Deserved Consult Payment With These Tips
Codes 99241-99245 are still viable in some cases. If your pulmonologist provided an of... Read more
Capture Deserved Consult Payment With These Tips
Codes 99241-99245 are still viable in some cases. If your pulmonologist provided an of... Read more
Readers Query:
Sound Out Your Payer Before Billing ANS Testing
Question: Our office just came across a case of ANS testing. Is it a payable service, i.... Read more
Sound Out Your Payer Before Billing ANS Testing
Question: Our office just came across a case of ANS testing. Is it a payable service, i.... Read more
Reader Query:
Check CCI Edits For Final Say on Spirometry Bundles
Question: I am going to bill 94150 and 94726. The CCI edits do not show the codes b... Read more
Check CCI Edits For Final Say on Spirometry Bundles
Question: I am going to bill 94150 and 94726. The CCI edits do not show the codes b... Read more
Reader Query:
Safely Report Critical Care and Consult On the Same Day
Question: We recently had this type of claim. Hospital Consultation/ (High Complexi... Read more
Safely Report Critical Care and Consult On the Same Day
Question: We recently had this type of claim. Hospital Consultation/ (High Complexi... Read more
You Be the Coder:
Press the Pause Button Before Billing Oximetry and E/M Together
Question:We are billing an evaluation and management (E/M) code 99212 along with a pulse... Read more
Press the Pause Button Before Billing Oximetry and E/M Together
Question:We are billing an evaluation and management (E/M) code 99212 along with a pulse... Read more
Allergic Alveolitis:
Ask Yourself These 3 Questions to Get the Best Out of EAA Claims
Ignoring CCI bundling in PFT codes may land you in hot water. If your practice is in t... Read more
Ask Yourself These 3 Questions to Get the Best Out of EAA Claims
Ignoring CCI bundling in PFT codes may land you in hot water. If your practice is in t... Read more
E/M Alert:
Watch Out for These E/M Coding Traps
Keeping a keen eye out for common documentation errors will ensure coding success. Eve... Read more
Watch Out for These E/M Coding Traps
Keeping a keen eye out for common documentation errors will ensure coding success. Eve... Read more
ICD-10 Prep:
These Tips Help You Manage Your ICD-10 Transition Jitters
Keeping handy a list of most frequent diseases will greatly improve your response-time e... Read more
These Tips Help You Manage Your ICD-10 Transition Jitters
Keeping handy a list of most frequent diseases will greatly improve your response-time e... Read more
Readers Question:
Keep an Eye Out for Distinct E/M Services Rendered to Recoup Max Payment
Question: Our pulmonologist recently attended to an established patient with anxiet... Read more
Keep an Eye Out for Distinct E/M Services Rendered to Recoup Max Payment
Question: Our pulmonologist recently attended to an established patient with anxiet... Read more
Readers Question:
Double Check Vaccine and Administration Code Checklist Before Claiming Pneumovax Shots
Question: What are the correct CPT® codes used to bill for a pneumovax in Medic... Read more
Double Check Vaccine and Administration Code Checklist Before Claiming Pneumovax Shots
Question: What are the correct CPT® codes used to bill for a pneumovax in Medic... Read more
Reader Question:
Fall Back on 96999 for Reporting Unlisted Allergy Test
Question: A patient reported to our office with wheezing, shortness of breath, and ... Read more
Fall Back on 96999 for Reporting Unlisted Allergy Test
Question: A patient reported to our office with wheezing, shortness of breath, and ... Read more
You Be the Coder:
Treat Second Opinion/Consult as Standard E/M
Question: Our pulmonologist recently saw a pediatric patient who was seen six month... Read more
Treat Second Opinion/Consult as Standard E/M
Question: Our pulmonologist recently saw a pediatric patient who was seen six month... Read more