Pulmonology Coding Alert
Critical Care:
5 FAQs Solve Your Critical Care Coding Conundrums
Every time a new year rolls around, it's a good time to shore up your coding and billing s... Read more
5 FAQs Solve Your Critical Care Coding Conundrums
Every time a new year rolls around, it's a good time to shore up your coding and billing s... Read more
Clip And Save:
Consult This Chart for Quick Critical Care Guidance
Tie together all the facts that you've learned about critical care coding in this issue by... Read more
Consult This Chart for Quick Critical Care Guidance
Tie together all the facts that you've learned about critical care coding in this issue by... Read more
2018 Payments:
CMS Sets Payment Rates for New Pulmonology Codes
Hint: Expect the status quo in chest x-ray payments, despite new codes. As pulmonology pr... Read more
CMS Sets Payment Rates for New Pulmonology Codes
Hint: Expect the status quo in chest x-ray payments, despite new codes. As pulmonology pr... Read more
E/M Coding:
Consider These E/M Tips Straight From Part B MAC Reps
Could your payer be using the '4x4 method' to calculate your exam elements? Determining t... Read more
Consider These E/M Tips Straight From Part B MAC Reps
Could your payer be using the '4x4 method' to calculate your exam elements? Determining t... Read more
Reader Question:
Know When You Can Collect Deductibles, Coinsurance
Question: We always collect copays up-front, but we usually bill out deductibles and coins... Read more
Know When You Can Collect Deductibles, Coinsurance
Question: We always collect copays up-front, but we usually bill out deductibles and coins... Read more
Reader Question:
What Is A Health IT Audit?
Question: We recently hired a new law firm to handle our privacy practices and they t... Read more
What Is A Health IT Audit?
Question: We recently hired a new law firm to handle our privacy practices and they t... Read more
You Be the Coder:
Get to Know the 2018 Flu Shot Codes
Question: We give quite a few flu shots at our pulmonology practice, and the doctor said s... Read more
Get to Know the 2018 Flu Shot Codes
Question: We give quite a few flu shots at our pulmonology practice, and the doctor said s... Read more
CPT® 2018:
CPT® to Overhaul Chest X-Ray Codes Effective Jan. 1
Plus : Forget what you know about coding pulmonary stress testing. Although the ink is ba... Read more
CPT® to Overhaul Chest X-Ray Codes Effective Jan. 1
Plus : Forget what you know about coding pulmonary stress testing. Although the ink is ba... Read more
ICD-10:
Establish Severity to Make Asthma Coding Easier
Tip: Don't forget to code out to the fifth character in most cases. When a patient presen... Read more
Establish Severity to Make Asthma Coding Easier
Tip: Don't forget to code out to the fifth character in most cases. When a patient presen... Read more
Billing:
3 Tips Smooth the Transition to Outsourcing Your Billing
Claims can process smoothly if you take these considerations to heart. Although many pulm... Read more
3 Tips Smooth the Transition to Outsourcing Your Billing
Claims can process smoothly if you take these considerations to heart. Although many pulm... Read more
Reader Question:
Don't Automatically Reach for "T" Allergy Codes
Question: A patient came in suffering from allergies, but we weren't able to pinpoint... Read more
Don't Automatically Reach for "T" Allergy Codes
Question: A patient came in suffering from allergies, but we weren't able to pinpoint... Read more
Reader Question:
Get the Facts on EHR Risk Analysis
Question: Our practice's attorney asked us if we've performed an EHR risk analysis ye... Read more
Get the Facts on EHR Risk Analysis
Question: Our practice's attorney asked us if we've performed an EHR risk analysis ye... Read more
You Be the Coder:
Appeal Modifier 22 Denials When Necessary
Question: I have a question about your modifier 22 article from last month ("Modifier... Read more
Appeal Modifier 22 Denials When Necessary
Question: I have a question about your modifier 22 article from last month ("Modifier... Read more
Medical Records Coding Quiz:
3 Breathing Treatment Scenarios, 3 Coding Challenges
Find out whether you can find the right codes for these common services. As a pulmonology... Read more
3 Breathing Treatment Scenarios, 3 Coding Challenges
Find out whether you can find the right codes for these common services. As a pulmonology... Read more
Modifiers:
Modifier 22 Isn't Just for Surgeons
Pulmonologists should use this modifier whenever procedures involve increased work. Could... Read more
Modifier 22 Isn't Just for Surgeons
Pulmonologists should use this modifier whenever procedures involve increased work. Could... Read more
Non-physician Practitioners:
Modifier SA Is Suddenly Critical With This Payer
When an APP performs an E/M, modifier SA will be essential when billing UHC. No matter ho... Read more
Modifier SA Is Suddenly Critical With This Payer
When an APP performs an E/M, modifier SA will be essential when billing UHC. No matter ho... Read more
Reader Question:
Can We Bill Other Services With 6-Minute Walk Test?
Question: We often perform testing before and after the 6-minute walk test. Are we ab... Read more
Can We Bill Other Services With 6-Minute Walk Test?
Question: We often perform testing before and after the 6-minute walk test. Are we ab... Read more
You Be the Coder:
Code This Sleep Apnea Visit
Question: A 58-year-old male patient came to our office complaining of restlessness d... Read more
Code This Sleep Apnea Visit
Question: A 58-year-old male patient came to our office complaining of restlessness d... Read more
Part B Fee Schedule:
Proposed Fee Schedule Suggests Big Changes to Chest X-Ray Coding
Plus: Check out these potential changes to E/M documentation, lung tumor ablation codes. ... Read more
Proposed Fee Schedule Suggests Big Changes to Chest X-Ray Coding
Plus: Check out these potential changes to E/M documentation, lung tumor ablation codes. ... Read more
Behind the Numbers:
Find Out How the MPFS Proposal Could Impact Your Pay
Are fees going up or down? Potential changes to E/M codes aren't the only shakeup that CM... Read more
Find Out How the MPFS Proposal Could Impact Your Pay
Are fees going up or down? Potential changes to E/M codes aren't the only shakeup that CM... Read more
Modifiers:
This BCBS Payer Just Slashed Modifier 25 Pay
Pulmonology practices could suffer when billing this insurer. If your pulmonology practic... Read more
This BCBS Payer Just Slashed Modifier 25 Pay
Pulmonology practices could suffer when billing this insurer. If your pulmonology practic... Read more
E/M Coding:
Still Billing Consults? Differentiate From Transfer of Care With These Tips
Remember Medicare's no-go consult rule first and foremost. When CMS stopped paying for co... Read more
Still Billing Consults? Differentiate From Transfer of Care With These Tips
Remember Medicare's no-go consult rule first and foremost. When CMS stopped paying for co... Read more
Reader Question:
Know When Balance Write-offs Are the Right Choice
Question: At my last practice, we used to write off patient balances whenever they we... Read more
Know When Balance Write-offs Are the Right Choice
Question: At my last practice, we used to write off patient balances whenever they we... Read more
Reader Question:
Get the Scoop on Team Conferences
Question: Can you give me some insight into medical team conference code 99366? We ha... Read more
Get the Scoop on Team Conferences
Question: Can you give me some insight into medical team conference code 99366? We ha... Read more
You Be the Coder:
Are ED Codes Site-Specific?
Question: Our pulmonologist saw a patient in his office for an emergency. Can I use t... Read more
Are ED Codes Site-Specific?
Question: Our pulmonologist saw a patient in his office for an emergency. Can I use t... Read more
ICD-10-CM:
Breaking: You'll Find Updates for COPD, Asthma Coding on Oct. 1
CMS has released the finalized list of 2018 diagnosis codes. Pulmonology coders hoping to... Read more
Breaking: You'll Find Updates for COPD, Asthma Coding on Oct. 1
CMS has released the finalized list of 2018 diagnosis codes. Pulmonology coders hoping to... Read more
Advance Beneficiary Notices:
CMS's Recent ABN Update Makes This A Good Time to Brush up on Skills
The new form went into effect June 21 — how is your ABN IQ? With CMS updating the A... Read more
CMS's Recent ABN Update Makes This A Good Time to Brush up on Skills
The new form went into effect June 21 — how is your ABN IQ? With CMS updating the A... Read more
Compliance:
3 Recent Cases Show Pulmonology Fraud Vulnerabilities
Secure your practice’s compliance plan to ensure audit success. Between Medicare, M... Read more
3 Recent Cases Show Pulmonology Fraud Vulnerabilities
Secure your practice’s compliance plan to ensure audit success. Between Medicare, M... Read more
Reader Question:
Get the Scoop on Pulmonary Rehab Coding
Question: We reported G0424 (Pulmonary rehabilitation, including exercise [includes m... Read more
Get the Scoop on Pulmonary Rehab Coding
Question: We reported G0424 (Pulmonary rehabilitation, including exercise [includes m... Read more
Reader Question:
Know How Many Dx Codes to Bill
Question: Must we report the ICD-10 codes for all the current conditions that the pat... Read more
Know How Many Dx Codes to Bill
Question: Must we report the ICD-10 codes for all the current conditions that the pat... Read more
You Be the Coder:
Get the 411 on V/Q Study Coding
Question: Our physician documented a “V/Q study.” What is this and which ... Read more
Get the 411 on V/Q Study Coding
Question: Our physician documented a “V/Q study.” What is this and which ... Read more
ICD-10-CM:
Proposed ICD-10 Codes Could Change Your Mesothelioma Coding in October
At last, coders may finally have a place to turn for secondary mesothelioma and other cond... Read more
Proposed ICD-10 Codes Could Change Your Mesothelioma Coding in October
At last, coders may finally have a place to turn for secondary mesothelioma and other cond... Read more
Coding Errors:
CMS: Pulmonologists Logged Sky-High Initial Hospital Visit Error Rates
Avoid making the same mistakes these doctors made. You see a patient in the hospital and ... Read more
CMS: Pulmonologists Logged Sky-High Initial Hospital Visit Error Rates
Avoid making the same mistakes these doctors made. You see a patient in the hospital and ... Read more
Appeals:
Did You Submit A Claim With Clerical Errors? Look to Reopening
You may not need a full appeal in this instance, MAC staffers advise. It’s a common... Read more
Did You Submit A Claim With Clerical Errors? Look to Reopening
You may not need a full appeal in this instance, MAC staffers advise. It’s a common... Read more
Reader Question:
Nail Down Chest PT Codes
Question: A patient with cystic fibrosis received chest physical therapy in the offic... Read more
Nail Down Chest PT Codes
Question: A patient with cystic fibrosis received chest physical therapy in the offic... Read more
Reader Question:
Some Payers Will Reimburse Consults
Question: We saw a 55-year-old new patient who has been smoking for 30 years. She was... Read more
Some Payers Will Reimburse Consults
Question: We saw a 55-year-old new patient who has been smoking for 30 years. She was... Read more
Reader Question:
Be Ready to Answer EOB Questions
Question: One of our patients called the other day and asked us several questions abo... Read more
Be Ready to Answer EOB Questions
Question: One of our patients called the other day and asked us several questions abo... Read more
Reader Question:
Spirometry Must Be Supported With Specific ICD-10 Codes
Question: We performed spirometry and the doctor wrote that it was for “chronic... Read more
Spirometry Must Be Supported With Specific ICD-10 Codes
Question: We performed spirometry and the doctor wrote that it was for “chronic... Read more
You Be the Coder:
Get Specific When COPD Patient Has Bronchitis
Question: One of our COPD patients presented with bronchitis. Our pulmonologist wants... Read more
Get Specific When COPD Patient Has Bronchitis
Question: One of our COPD patients presented with bronchitis. Our pulmonologist wants... Read more
Auditors Launch Nebulizer Claim Reviews
Follow these steps to stay on the right side of the auditors’ gaze. It’s neve... Read more
Follow these steps to stay on the right side of the auditors’ gaze. It’s neve... Read more
The RACs Are Also Reviewing These Issues Applicable to Pulmonologists
Although nebulizers are the most pressing open RAC issues for pulmonology practices, these... Read more
Although nebulizers are the most pressing open RAC issues for pulmonology practices, these... Read more
Revenue Booster:
Check These Tips for Reporting the 5 Most-Frequently Billed Pulmonology Codes
This lightning round will help you report these often-reported services. Many pulmonology... Read more
Check These Tips for Reporting the 5 Most-Frequently Billed Pulmonology Codes
This lightning round will help you report these often-reported services. Many pulmonology... Read more
ICD-10:
Avoid These 3 Pulmonology Diagnosis Coding Myths
Myths lead to misdiagnoses — which can lead to chargebacks. You know that assigning... Read more
Avoid These 3 Pulmonology Diagnosis Coding Myths
Myths lead to misdiagnoses — which can lead to chargebacks. You know that assigning... Read more
Reader Question:
Get the Lowdown for State Refund Amounts
Question: Two years ago, we saw a patient who came to our office for shortness of bre... Read more
Get the Lowdown for State Refund Amounts
Question: Two years ago, we saw a patient who came to our office for shortness of bre... Read more
Reader Question:
This MAC Reveals How It Reviews Modifier 25 Claims
Question: Our office manager is always nervous when we submit a claim with modifier 2... Read more
This MAC Reveals How It Reviews Modifier 25 Claims
Question: Our office manager is always nervous when we submit a claim with modifier 2... Read more
You Be the Coder:
Tobacco Cessation Counseling Is Payable in Inpatient, Outpatient Settings
Question: Which Medicare patients qualify for tobacco cessation counseling? Codify S... Read more
Tobacco Cessation Counseling Is Payable in Inpatient, Outpatient Settings
Question: Which Medicare patients qualify for tobacco cessation counseling? Codify S... Read more
Coding Strategies:
What to Report When Asthma is Keeping Patients Up All Night
Don’t use 95803 with sleep studies and get your asthma dx right. Many of your asthm... Read more
What to Report When Asthma is Keeping Patients Up All Night
Don’t use 95803 with sleep studies and get your asthma dx right. Many of your asthm... Read more
Private Payers:
Renegotiate Your Payer Contracts: 5 Tactics Put You in the Driver's Seat
Gather your contracts and get your fee schedule details for all the codes you use. Do you... Read more
Renegotiate Your Payer Contracts: 5 Tactics Put You in the Driver's Seat
Gather your contracts and get your fee schedule details for all the codes you use. Do you... Read more
Payer Contracts:
7 Common Payer Contract Negotiation Mistakes You're Probably Making
Healthy skepticism is a good thing where contracts are concerned. The bigger and shrewder... Read more
7 Common Payer Contract Negotiation Mistakes You're Probably Making
Healthy skepticism is a good thing where contracts are concerned. The bigger and shrewder... Read more
Tool:
Payer Negotiations? Use This Checklist to Safeguard Your Profits
Watch out for auto-renew clauses, slow credentialing for new hires. Yes, you can stand yo... Read more
Payer Negotiations? Use This Checklist to Safeguard Your Profits
Watch out for auto-renew clauses, slow credentialing for new hires. Yes, you can stand yo... Read more
You Be the Expert:
Look to Extra Codes for Adverse Effects
Question: Our pulmonologist gave a theophylline prescription to a patient with asthma... Read more
Look to Extra Codes for Adverse Effects
Question: Our pulmonologist gave a theophylline prescription to a patient with asthma... Read more
Reader Question:
Checking on Patient with Cancer Hx May not Qualify as Preventive
Question: We saw a 36-year-old female patient who had successful treatment of cancer ... Read more
Checking on Patient with Cancer Hx May not Qualify as Preventive
Question: We saw a 36-year-old female patient who had successful treatment of cancer ... Read more
Reader Question:
Audits Go Far Beyond Medicare
Question: We recently got a letter asking us to submit some records for review. We do... Read more
Audits Go Far Beyond Medicare
Question: We recently got a letter asking us to submit some records for review. We do... Read more
Reader Question:
Advance Care Planning Payment Has Strings Attached
Question: Our physician saw a patient for advance care planning and reported 99497 fo... Read more
Advance Care Planning Payment Has Strings Attached
Question: Our physician saw a patient for advance care planning and reported 99497 fo... Read more
Heed These In-House Moderate Sedation Changes
What you need to know about tracking intraservice work. New moderate sedation codes have ... Read more
What you need to know about tracking intraservice work. New moderate sedation codes have ... Read more
Get the Most Out of MIPS in 2017 for Your Pulmonology Billing
This guide to MIPS reporting and pulmonology-specific Quality Measures will maximize your ... Read more
This guide to MIPS reporting and pulmonology-specific Quality Measures will maximize your ... Read more
Want to Increase Your Profitability? How Benchmarks Can Help
Experts offer 9 benchmarks to measure your practice’s financial health. Is your ph... Read more
Experts offer 9 benchmarks to measure your practice’s financial health. Is your ph... Read more
You Be the Expert:
Scrutinize Diagnosis for At-Home Spirometry
Question: One of our patients has unstable bronchospasms due to emphysema and therefo... Read more
Scrutinize Diagnosis for At-Home Spirometry
Question: One of our patients has unstable bronchospasms due to emphysema and therefo... Read more
Reader Question:
Don't Expect Bilateral Bronchosopy Payment
Question: Our pulmonologist performed bronchioloalveolar biopsy of the left upper lob... Read more
Don't Expect Bilateral Bronchosopy Payment
Question: Our pulmonologist performed bronchioloalveolar biopsy of the left upper lob... Read more
Reader Question:
99211 Isn't All-Encompassing
Question: A patient presented to our office for a chest x-ray, but before the doctor ... Read more
99211 Isn't All-Encompassing
Question: A patient presented to our office for a chest x-ray, but before the doctor ... Read more
Reader Question:
Doctors, Billers Aren't Communicating? Make It Happen
Question: As the office manager in my practice, I am often stuck in the middle betwee... Read more
Doctors, Billers Aren't Communicating? Make It Happen
Question: As the office manager in my practice, I am often stuck in the middle betwee... Read more
Revenue Strategies:
Invest in Mobile Patient Engagement? 4 Questions Help You Decide
Revenue cycle benefits, self-service options are strong positives. If you’re intere... Read more
Invest in Mobile Patient Engagement? 4 Questions Help You Decide
Revenue cycle benefits, self-service options are strong positives. If you’re intere... Read more
Billing:
Keep Credit Card Numbers on File and Speed Up Your Payment Time
Trim days in A/R from 90 to 30. One area of growth you don’t want to see is an incr... Read more
Keep Credit Card Numbers on File and Speed Up Your Payment Time
Trim days in A/R from 90 to 30. One area of growth you don’t want to see is an incr... Read more
Apply These Telehealth Indicators to Recoup for Your Distance Treatment Services
When to use POS 02 and modifiers GT, GQ, 95. When your pulmonologist delivers approved te... Read more
When to use POS 02 and modifiers GT, GQ, 95. When your pulmonologist delivers approved te... Read more
Test COPD and Asthma Coding Skills With These 4 Scenarios
Clinical signs of moderate and mild asthma to drive your choice of codes. You report COPD... Read more
Clinical signs of moderate and mild asthma to drive your choice of codes. You report COPD... Read more
Reader Question:
Can You Freeze the Code for Influenza Prior to Investigations?
Question: A 50-year-old female patient complains of flu-like symptoms. The provider e... Read more
Can You Freeze the Code for Influenza Prior to Investigations?
Question: A 50-year-old female patient complains of flu-like symptoms. The provider e... Read more
Reader Question:
Go By Documentation to Get Accurate Laryngoscopy Code
Question: The provider removed a foreign body in the throat using the laryngoscope. A... Read more
Go By Documentation to Get Accurate Laryngoscopy Code
Question: The provider removed a foreign body in the throat using the laryngoscope. A... Read more
Reader Question:
Know Your Smoking Cessation Codes
Question: A smoker for 20 years, with breathing problems, came to the provider. The p... Read more
Know Your Smoking Cessation Codes
Question: A smoker for 20 years, with breathing problems, came to the provider. The p... Read more
You Be the Coder:
Advanced Care Planning
Question: Which settings are eligible to bill for the advanced care planning services... Read more
Advanced Care Planning
Question: Which settings are eligible to bill for the advanced care planning services... Read more
CPT® 2017:
Tread Carefully as Flu Vaccine Coding Undergoes a Drastic Overhaul
CPT® revises eight codes to reflect dosage, rather than patient age Are you up to ... Read more
Tread Carefully as Flu Vaccine Coding Undergoes a Drastic Overhaul
CPT® revises eight codes to reflect dosage, rather than patient age Are you up to ... Read more
Pulmonary Rehabilitation:
Power Up Your PR Claims with This Coverage Insight
Hint: The diagnosis is COPD is crucial. Do you have to come out with guns blazing to s... Read more
Power Up Your PR Claims with This Coverage Insight
Hint: The diagnosis is COPD is crucial. Do you have to come out with guns blazing to s... Read more
ICD-10 Coding Quiz:
Test your Coding Skills with Pansinusitis, Sore throat, and More
Take a closer look at NOS codes to shore up. Your success in 2017 will largely depend ... Read more
Test your Coding Skills with Pansinusitis, Sore throat, and More
Take a closer look at NOS codes to shore up. Your success in 2017 will largely depend ... Read more
Reader Question:
Pull the Plug on Coding For Same-Day Multiple Inhalation Treatments
Question: A known asthmatic patient presented with acute breathlessness. The provid... Read more
Pull the Plug on Coding For Same-Day Multiple Inhalation Treatments
Question: A known asthmatic patient presented with acute breathlessness. The provid... Read more
You Be the Coder:
Know How to Report a Bronchial Blocker
Question: The provider, while doing a diagnostic bronchoscopy of the right lung, fo... Read more
Know How to Report a Bronchial Blocker
Question: The provider, while doing a diagnostic bronchoscopy of the right lung, fo... Read more
CPT® 2017:
Ace Your Sleep Apnea Coding With 13 New Category III Codes
Don’t lose sleep over exclusive codes for removal, replacement, repositioning and ... Read more
Ace Your Sleep Apnea Coding With 13 New Category III Codes
Don’t lose sleep over exclusive codes for removal, replacement, repositioning and ... Read more
V/Q Study:
Breathe Life Into Your V/Q Study Claims with These 4 Pointers
Look for documentation details when choosing between 78579, 78580 and 78582. How confi... Read more
Breathe Life Into Your V/Q Study Claims with These 4 Pointers
Look for documentation details when choosing between 78579, 78580 and 78582. How confi... Read more
ICD-10 Update:
Nail Down Your Coding Options for Pneumonia
Pinpoint the causative organism to wade through fifty plus choices. Does choosing the ... Read more
Nail Down Your Coding Options for Pneumonia
Pinpoint the causative organism to wade through fifty plus choices. Does choosing the ... Read more
Reader Question:
Know How To Bill for Additional Education of MDI Device
Question: An asthmatic patient presents with complaints of wheezing and difficulty ... Read more
Know How To Bill for Additional Education of MDI Device
Question: An asthmatic patient presents with complaints of wheezing and difficulty ... Read more
You Be the Coder:
Explore Your Options for Foreign Body Removal Using Laryngoscopy
Question: The provider did a laryngoscopy along with removal of a foreign body. Ple... Read more
Explore Your Options for Foreign Body Removal Using Laryngoscopy
Question: The provider did a laryngoscopy along with removal of a foreign body. Ple... Read more