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Pulmonology Coding Alert

EBUS Coding:
Clear Up Multiple EBUS Coding Confusion
Decipher when to report 31629 along with 31652 or 31653. The new endobronchial ultraso... Read more
CT Scans:
Here's How to Establish Medical Necessity and Counter CT Services Denials
Using modifier CT? Brace yourself for a 15 percent cut in 2017. Have you been facing ... Read more
Quality Measures:
Get Ready To Report This New Revised Bronchodilator Measure In 2017
ATS adds specificity to the bronchodilator measure #52 Come January, and your provider... Read more
ICD-10 Update:
Explore Your Pneumopathy Coding Options with J66 Category
Investigate occupational history to arrive at the specific diagnosis. Coding for lung ... Read more
Reader Question:
Stay Flexible With Use of GW Modifier
Question: We have a Pulmonary Critical Care specialist we are billing for. We have a ... Read more
Reader Question:
Solve the Immunotherapy Coding Dilemma At Last
Question: What is the proper way to bill for CPT® code 95165 preparation and supervi... Read more
You Be the Coder:
Crack Down the Codes for Multiple Nasal Polyps
Question: The provider performed removal of multiple nasal polyps. How do we report this? ... Read more
Advanced Care Planning:
Advance Your Coding Abilities for Advance Care Planning With This Advice
Work through this COPD case study reporting 99497 and 99498. Are you prepared to capture ... Read more
ICD-10 Update:
ICD-10 Pulmonology Coding Mistakes You Cannot Afford To Make
Don’t just correct, perfect your respiratory failure and seventh character coding.... Read more
Smoking Cessation:
Report Your Smoking Cessation Counseling Services with These 2 Codes
Erase the smoking cessation G-codes from your code list this year. Did you miss this ... Read more
Reader Question:
Clear Up the Confusion on Coding For Laryngoscopy with FBR
Question: A 20 years old male presents with complaint of “something irritatin... Read more
Reader Question:
Put Your Thinking Cap On for This Bronchoscopy Case
Question: The provider performs bronchoscopy, uses a flexible bronchoscope to view an... Read more
Reader Question:
Here's How to Capture the PC of Sleep Study
Question: Our pulmonologist interpreted a sleep study report for Medicare patient. ... Read more
You Be the Coder:
Master the Codes for Ventilator Associated Pneumonia
Question: A patient developed ventilator associated pneumonia while undergoing treatm... Read more
CPT® 2017 Update:
Here's Your First Glimpse at the CPT® 2017 Update for Pulmonology
Bronchoscopy codes will no longer include conscious sedation. As the year starts windi... Read more
Xolair Coding:
Breathe Easy With Xolair Administration Reporting
Know why you should choose 96372 above the rest. Are you too stuck in a dilemma to ch... Read more
ICD-10 Update:
Brace Yourself for the Real Grind As Medicare Flexibility Expires Oct. 1
Avoid unspecified ICD-10 codes, CMS says. Get ready to face the real brunt of the ICD-... Read more
Reader Question:
Report Respiratory Failure, Pulmonary Infiltrates Separately
Question: Can you code acute respiratory failure and pulmonary infiltrates together... Read more
Reader Question:
Know If You Can Bill 31625, 31628 and 31629 Together
Question: Can we bill together 31628, 31629 and 31625 for the same LLL? Mississip... Read more
Reader Question:
Use 95165, 95117 for Allergy Immunotherapy Services
Question: What is the proper way to bill for CPT® code 95165 preparation and su... Read more
Reader Question:
Get the Right Code for Drainage of a Nasal Abscess
Question: A provider aspirates the excess fluid from an abscess within the nasal ca... Read more
You Be the Coder:
Six Minute Walk Test in a Case of Pulmonary Hypertension
Question: What CPT® code should I use for a six-minute walk test for a patient ... Read more
CPT® Coding:
Pulmonary Function Tests: Correct Pairing of Codes Holds the Key to Success
Tread cautiously while pairing 94010 with 94060 or 94070. Pulmonary function testing c... Read more
ICD-10:
Breathe Easy When Coding COPD, Thanks to This ICD-10 Refresher
Don’t miss these 2017 tweaks to your Excludes notes. ICD-10-CM provides some cla... Read more
Policy/Reimbursement:
Don't Let a Potential Delay in MACRA Implementation Catch You Off-Guard
CMS may publish interim final rule for additional feedback. Your reporting as per the Med... Read more
Reader Question:
Know Which Patients Qualify For Smoking Cessation Counseling
Question: Which patients qualify for face to face smoking cessation counseling serv... Read more
Reader Question:
Grab the Root Cause of Influenza
Question: How do we get to know the accurate code for influenza in ICD-10-CM? ... Read more
Reader Question:
Here's How to Report Prolonged Service for Asthma
Question: A 40 year old gentleman, a known asthmatic, came in with respiratory dist... Read more
Reader Question:
Bill E/M Service Along With Advance Care Planning
Question: Is it possible to bill for an E/M service along with an advance care plan... Read more
You Be the Coder:
Keep the Billable Units in Mind for JW Modifier
Question: What is the best way to use the JW Modifier? Texas Subscriber Answer:&nbs... Read more
Policy/Reimbursement:
Cut Short the Dilemma of Using Prolonged Services Codes
New and revised codes change how you report prolonged care by clinical staff. Are you ... Read more
Reimbursement/Coding:
Crosscheck Your EBUS Denials Now
Revised NCCI edits bring hope for bronchoscopy denials. Get ready for good news if you... Read more
ICD-10 Update:
CMS Doles Out the Final ICD-10-CM Update
Major revisions to postprocedural hemorrhage, mediastinitis, and more. CMS finally rel... Read more
Reader Question:
How Many Times Can You Bill 94640?
Question: Our provider gave inhalation treatment to a patient with acute airway obs... Read more
Reader Question:
Know the Codes for PR Services for Non-COPD Patients
Question: Does Medicare cover the pulmonary rehabilitation services such as exercis... Read more
Reader Question:
Using Modifier 25 With Prolonged Services
Question: Can we report prolonged care services (CPT® code 99354-99357) along with m... Read more
Reader Question:
How to Bill 94664 and 94640 on the Same Day
Question: How can we bill for demonstration of flow operated inhaler devices, such ... Read more
You Be the Coder:
Yes, You Might Submit Bronchitis and URI on the Same Claim
Question: My physician has put both bronchitis and URI as diagnoses for a patient. ... Read more
Policy/Coding:
Avoid These 5 Deadly Mistakes for Lung Cancer Screening Claims
Use the right TOBs, and avoid facing claim adjustments. CMS now provides coverage for scr... Read more
Coding/Reimbursement:
Know What It Takes To Get Your Smoking Cessation Claims Paid
Do not miss using the appropriate ICD-10 codes, document 5 A’s, and more. Consid... Read more
Coding:
Master the Revised Codes for Inhalation Therapy
Use modifier76 to boost payments. With the changes for inhalation therapy codes, you n... Read more
ICD-10 Update:
Tackle Influenza with Precise ICD-10 Codes
Identify the causative influenza viruses first. Influenza coding requires a lot of ana... Read more
Reader Question:
Reporting Teaching Services Separate from Respiratory Therapy
Question: If the respiratory therapist evaluates an inpatient, is there a procedure... Read more
Reader Question:
Know What 94620 Has In Store for You
Question: My pulmonologist is sending patients for services covered by 94620. He is... Read more
Reader Question:
Bill These Three Bronchoscopy Codes Together
Question: Can we bill together 31628, 31629 and 31625 for procedures on the same lu... Read more
You Be the Coder:
Coding for Ventilator Management in the ED
Question: If a patient is put on a ventilator in the Emergency Department (ED), whi... Read more
Coding Update:
6 Tips Prepare You for Big Changes This Year
2016 has brought welcome changes for your practice. If you thought that advance care p... Read more
Policy/Coding:
Tread Cautiously With the New LDCT Lung Cancer Screening SDM Reporting
ATS approaches requirements critically, asks CMS two questions. Is your staff aware of... Read more
ICD-10 Update:
Less Is Better, When It Comes to ICD-10 Code Changes for Pulmonology
Postprocedural complications and mediastinitis add up to the J codes. Are you unnerved... Read more
Reader Question:
Are the New ICD-10 Codes Final?
Question: Is the new ICD-10-CM codeset for FY 2017 final? I have heard people sayin... Read more
Reader Question:
How to Use the New Prolonged Service Codes
Question: How can we use the new prolonged service codes? Maine Subscriber Answ... Read more
Reader Question:
How to Wade Through Bundling Issues with New EBUS Codes
Question: I’m having issues with the CCI edits bundling other bronchoscopies ... Read more
You Be the Coder:
Bill It Right for the Flutter Valve Demonstration
Question: How does one bill for teaching the patient how to use a flow operated inh... Read more
ICD-10 Update:
Explore Your Options in Respiratory Failure Coding
Follow the guidelines to code ARF correctly. Respiratory failure means the condition w... Read more
Practice Management:
Keep a Watchful Eye on Claims to Boost Your Pulmonologist's Pay
Follow these 4 tips for an up-to-date AR. In order to receive your deserved pay, you n... Read more
Compliance:
Report: Majority of Practices Caught Unprepared for HIPAA Audits
You aren't HIPAA compliant if you don't have a compliance officer. As practices nationwid... Read more
Reader Question:
Weigh It Right for the Lung Volumes
Question: We measured lung volume and now have been rejected for using code 94278. ... Read more
Reader Question:
Know the Coding Approach to Lung Biopsy and Resection
Question: If the pathologist examines a lung specimen that the surgeon identifies a... Read more
Reader Question:
Understand Whether E-Signatures Are as Acceptable as Handwritten
Question: What are the necessary requirements for physician signatures? Are E-signa... Read more
Reader Question:
Treat ER and Office Visits as Separate Encounters
Question: A patient was seen for an office visit (99214). Later on the same day she w... Read more
You Be the Coder:
How to Code for Lung Neoplasms With Metastasis
Question: The physician documented that the patient has a primary neoplasm of the r... Read more
CPT® Coding Strategies:
Ask Yourself These 4 Questions for Successful Thoracentesis/ Pleural Drainage Claims
Watch for scenarios needing bilateral claims. Whenever your pulmonologist removes flui... Read more
E/M Coding:
Realize the Importance of HPI in Determining Your E/M Level
Ensure that payer recognizes 'duration' before counting it on HPI. Whenever your pulmonol... Read more
Compliance:
Don't Allow Insurance Verification Delays Cost Your Practice Hundreds of Dollars
Experts: Make sure patient’s insurance info is valid before first visit. In your... Read more
Reader Question:
Confused About Reporting Multiple Biopsies in a Lobe? Here's What to do
Question: Our pulmonologist recently performed a flexible bronchoscopy during which... Read more
Reader Question:
Wondering About Giving EOB Explanations to Patients? Here's How
Question: We often get patients who call the practice with questions about their ex... Read more
You Be the Coder:
Don't Always Reach to E/M During Allergy Injection Visits
Question: If a patient came to our practice to receive allergy injections that were... Read more
Sleep Tests:
4 Rules Help You Secure Your Reimbursement for Sleep Studies and Polysomnography
Age, stage, and parameters all point you to the best codes. If you code for facility-... Read more
Part B Update:
You Are Not Bound to Accept Each and Every New Medicare Patient
MACs also clarify doubts over “incident to” and “shared/split” s... Read more
Compliance Matters:
Count on ABNs to Salvage Your Reimbursement for Uncovered Services
Keep records of unsigned ABN on file even if patient does not sign and return the ABN befo... Read more
Readers Question:
Get Paid for Visit by Reporting Symptoms in Absence of Confirmed Dx
Question: A new patient reported to our physician office complaining of wheezing an... Read more
Reader Question:
Don't Expect to Get Paid for Translator Service in Medicare Cases
Question: Recently, we had to use a translator for a Medicare patient. I am thinkin... Read more
Reader Question:
Don't Code Built-In Service as Separate E/M
Question: In our office, a nurse practitioner (NP) saw a 65-year-old established pa... Read more
You Be the Coder:
Tone Down E/M for Non-Complicated Revisits
Question: Our pulmonologist recently saw an established pneumonia patient. Her of... Read more
Inhalation Treatment:
4 Rules Rev Up Your Reimbursement for Nebulizer Treatment
Talk to your physician to choose correctly between coding prolonged services or a higher... Read more
E/M Encounters:
2 Tips Help You Prep for Pulmonary Diagnosis Coding in Pre-Op Clearance Visits
Visit setting and type of payer will determine coding for an E/M service before surgery.... Read more
Flu Vaccines:
90630 Adds More Firepower to Your Influenza Coding Armory
Expect to start getting paid for the code by April. CPT® added a new influenza vac... Read more
E/M Errors:
Take Corrective Action Fast to Reduce Possibly Inflated E/M Claims that CERT has Flagged
Even NPP claims are equal culprits. Audit studies have always found evaluation and ma... Read more
Readers Question:
Immunotherapy and E/M Service Can Go Hand in Hand
Question: My pulmonologist assessed a patient suffering from severe pain and fever ... Read more
Readers Question:
Spot Modifier 76 Applicability In Therapeutic Intervention
Question: A patient presents to the office with an allergic reaction to chlorine afte... Read more
You Be the Coder:
Beware of Ownership Issues Before Billing Pulse Oximeter Reading
Question: Is it true that I should only report 94762 as a technical component? Ther... Read more
Pulmonary Embolism:
4 Golden Rules Show You How To Breathe Easy When Reporting Septic Embolisms
The presence or absence of this added complication virtually decides your diagnosis. ... Read more
Medicare Compliance:
Curb Incorrect E/M Coding Cases to Stay Clear of CMS Scrutiny
Medicare finds Part B error rate worsening year-on-year. Despite the renewed interest ... Read more
Reimbursement News:
Factor in These Billing and Policy Updates to Maintain a Healthy Bottom Line
Don’t expect all CMS proposed changes to be implemented. Although your practice ... Read more
Billing Corner:
Confirm 'Established Plan of Care' to Avoid Rejection of NPP Services Billing
Definition of new condition is crucial to distinguish incident-to services. If your pu... Read more
Reader Question:
Primary Procedure Code Precedes 31627
Question: Our pulmonologist saw a patient with breathing difficulties and blood in the c... Read more
You Be the Coder:
Eschew E/M Payment When Billing a Flu Shot
Question: When patients come in for a flu shot, our nurse sees the patient first. She do... Read more
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