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Pulmonology Coding Alert

CPT® 2021:
Look for New Pulmonary Function Test Code in January
Plus: You'll find five deleted PFT codes in 2021. You've been awaiting the looming update... Read more
Telehealth Coding:
CMS Adds Pulmonary Rehab to Telehealth List
Coverage is retroactive to March 1, 2020. If you've talked to patients who are concerned ... Read more
E/M Coding:
Tighten Your Inpatient E/M Coding With These Quick Tips
Remember that inpatient E/M rules won't change in 2021. Most pulmonology coders have s... Read more
You Be the Coder:
Get to the Bottom of Sequencing for Inpatient COVID-19
Question: In a previous issue, you discussed a case where the pulmonologist treated a pati... Read more
Reader Questions:
Heed NCCI for Nebulizer Coding
Question: A patient with a new diagnosis of asthma came to our practice and we educated he... Read more
Reader Questions:
Go Beyond J30.2 for Hay Fever
Question: We have been coding J30.2 (Other seasonal allergic rhinitis) for our hay fever p... Read more
Reader Questions:
Report Signs, Symptoms When COPD Isn’t Confirmed
Question: We saw a patient who presented because she was concerned that she may have COPD.... Read more
Nurse Practitioner Coding:
How Do Your NPs Stack up When Reporting High-Level E/M Services?
How Do Your NPs Stack up When Reporting High-Level E/M Services? Report indicates a nearl... Read more
E/M Coding:
Tighten Your E/M Coding Knowledge With 3 Quick FAQs
These regulations won't change in 2021, so ensure you know them well. As every pulmonolog... Read more
Annual Wellness Visits:
Document AWV Services Properly With These Quick Tips
Preventive screening schedule is essential, MAC rep says. Although your pulmonologists m... Read more
You Be the Coder:
How Should You Report Low-Level New Patient E/M Codes in 2021?
Question: We are finally getting around to training our staff on how the outpatient E/M co... Read more
Reader Questions:
Get the Scoop on Modifier CS
Question: One of our private insurers is requiring us to append modifier CS to all line it... Read more
Reader Questions:
HIPAA Does Not Supersede Patient Outreach
Question: We've ordered COVID-19 testing for many patients and have identified some patie... Read more
Reader Questions:
Determine How to Report Split/Shared Visits
Question: Can qualified advanced practice providers (APPs) “split” a service with a ph... Read more
E/M Visits:
6 Tips Help You Prepare for 2021 E/M Changes
Not sure how your documentation will stand up? Consider a peer audit. The new edition of ... Read more
Sleep Studies:
Accurately Code Sleep Tests With These Quick Hints
Remember: Don't classify all sleep studies as polysomnography. From electroencephalogram ... Read more
Reimbursement:
Pulmonologists Could See Benefits From Fee Schedule Proposal
Plus: The government has proposed expanding telehealth into 2021. If your pulmonology pra... Read more
Reader Questions:
Know the Approved Telehealth Services
Question: Can we report 94060 for continuous positive airway pressure ventilation (CPAP) i... Read more
Reader Questions:
Signs, Symptoms Might Work Best for Some Visits
Question: We saw a patient for a cough, and the pulmonologist wanted the patient to get te... Read more
You Be the Coder:
How Should You Code 20 Minutes of Critical Care?
Question: Which code should we report if the physician sees a critically ill patient for l... Read more
ICD-10 Coding:
New Diagnosis Codes Describe Pulmonary Eosinophilia in Detail
Documentation will be key to finding info to determine the right codes. As many coders ma... Read more
CMS Issues Updated ABN
In addition to releasing the new ICD-10 codes, CMS also debuted an updated advance benefic... Read more
Compliance:
Are Your Telehealth Claims Missing These Key Details?
If so, you could be facing massive audits very soon. As most practices are aware, the gov... Read more
Include These Items in Your Telehealth Documentation
To ensure that your telehealth and phone visits stack up against provider audits, ensure t... Read more
E/M 2021:
Prep Now for Upcoming E/M Changes With These MDM Tips
Don't expect to get away with lax documentation in January, experts say. Your pulmonolo... Read more
You Be the Coder:
Are You Checking Your MUEs?
Question: We billed a patient's insurance plan for 92 units of allergy immunotherapy using... Read more
Reader Questions:
Get the Scoop on Telehealth-Turned-In-Person Visit
Question: If a visit starts as telehealth and the patient then comes to the office for an ... Read more
Reader Questions:
Watch Supervision Requirements for Incident-to
Question: If the physician and a nurse practitioner are in contact over the phone — but ... Read more
E/M Coding:
3 Tips Help Clarify Your E/M Coding Questions
Don't be afraid to write in your CPT® code book. When it comes to E/M coding, you h... Read more
Accounts Receivable:
Are You Overlooking These Ways Your Practice Can Bring in More Money?
Determine whether you're missing these sources of cash in your practice. Many pulmonology... Read more
Telehealth Services:
Check These Telehealth Reporting Tips Straight From the MAC
Hint: There isn't yet a date for the end of the public health emergency. Most pulmonology... Read more
Reader Questions:
Get to Know What Constitutes Family History
Question: Our pulmonologist documented “No sick contacts.” Would this be enough t... Read more
Reader Questions:
Know When the Global Period Applies
Question: Can our practice bill for immunosuppressant visits during the global period... Read more
Reader Questions:
Get to Know the e-Visit Codes
Question: Which E/M codes should I use if I see a patient for an e-visit? We have bee... Read more
You Be the Coder:
Do You Know the Phone Consultation Codes?
Question: Our pulmonologist was using an online app to consult with another pulmonolo... Read more
E/M Coding:
Avoid These Common HPI Issues to Pinpoint the Most Accurate History Level
Selecting between the two HPI levels isn't like flipping a coin. Although your practice ... Read more
ICD-10 Coding:
Straighten Out Your Diagnosis Coding With 3 FAQs
Not sure which ICD-10 code to list first? Consider these strategies. Diagnosis coding oft... Read more
Modifiers:
These E/M Modifiers Are Common — But the Coding Rules Remain Confusing
Part B reps cleared up some frequent inaccuracies about these modifiers. Your pulmonology... Read more
Reader Question:
Can You Eliminate History, Exam Components in January?
Question: Since history and exam will no longer be key components for determining the leve... Read more
Reader Question:
Does Your Office Have a 'Most Wanted' List?
Question: We recently performed a self-audit and found that there are certain issues that ... Read more
You Be the Coder:
Do You Know When Modifier CS Applies?
Question: We recently received a bulletin about modifier CS, but it was confusing and... Read more
Telehealth Coding:
3 FAQs Lead You to Telehealth Coding Success
Hint: Keep an eye on CMS' website to find out when adjusted rules subside. Your practice ... Read more
Ventilator Coding:
Check These Vent Management Best Practices
Avoid the most common errors to ensure payment success. As every pulmonologist is acute... Read more
E/M 2021:
Visualize E/M Coding Bliss Next Year with 3 Facts
Hint: You'll want to clock your time more accurately next year. You've got less than a ye... Read more
Reader Question:
Here's How to Differentiate HCPCS, CPT®
Question: When should we report HCPCS Level II codes versus CPT® codes? Are HCPCS Level I... Read more
You Be the Coder:
When Can You Add Documentation?
Question: When we see that documentation doesn't match a code choice, we usually go b... Read more
Coding Amid Coronavirus:
Medicare Expands Telehealth Coverage — Here's How to Report These Services
New regulations went into effect in March. Practices that have been frustrated about the ... Read more
Coding Amid Coronavirus:
Keep Sequencing in Mind for Coronavirus Diagnoses
Focus carefully on dates of service when selecting your diagnosis codes. The best way t... Read more
Medicare Advantage:
Perfect Your Medicare Advantage Claims With 7 Quick Tips
MA payers aren't the same as your local MAC. If your pulmonology practice sees Medicare A... Read more
Reader Question:
Keep Patient Privacy in Check During Pandemic
Question: We diagnosed a patient with coronavirus three days ago. Ever since, her husband ... Read more
Reader Question:
Codes for Critical Care Unit Visits Can Vary
Question: When our pulmonologist rounds on a patient in the critical care unit (CCU), can ... Read more
Reader Question:
Avoid Charging Patient for Records Transfer
Question: Our practice discharged a patient due to non-payment, and one week later a new p... Read more
You Be the Coder:
Can You Report Smoking Cessation Counseling for Asymptomatic Smoker?
Question: Our physician assistant (PA) performed smoking cessation counseling with a patie... Read more
E/M Coding:
Are You on Top of These 4 E/M Best Practices?
 See what the experts have to say about the issues they encounter. Pulmonologists re... Read more
These Are Pulmonologists' Most-Billed E/M Codes
If you're working on your E/M coding proficiency, it might be a good idea to get a handle ... Read more
Medicare Pay:
Navigate the Fee Schedule With These Expert Tips
Here's exactly what you can find inside the searchable database. From payment amounts to ... Read more
NCCI:
Get the Scoop on NCCI Edit Pairs With This Quick Primer
Consider the answers to these FAQs to understand how the code pairs work. When it comes t... Read more
Reader Question:
Vent Does Not Always Equate to Critical Care
Question: Our pulmonologist oversaw vent management for an inpatient last week and billed ... Read more
Reader Question:
Know When X-Ray Readings Are Billable
Question: A primary care provider (PCP) saw a patient complaining of difficulty breathing ... Read more
You Be the Coder:
Know How to Differentiate Acute from Chronic
Question: When should I code for an acute form of a condition as opposed to a chronic form... Read more
E/M Changes:
3 Tips Help You Prepare for Next Year's E/M Changes
Hint: Time could really be of the essence in 2021. Your E/M coding for new and establishe... Read more
Compliance:
Stay off Auditors' Radar Screens With Nine Key Tips
Reviewers are paying more attention to modifier misuse, experts say.> You've paid care... Read more
Medical Practice Tips:
Ensure That Your Pulmonology Practice Works More Efficiently This Year With These Tips
Make a formal error-checking process to keep your practice moving smoothly. No matter how... Read more
Reader Question:
Heed New Code for Vaping-Related Disorders
Question: We heard that a new code came out to describe when the pulmonologist addres... Read more
Reader Question:
Only Use 99422 for Established Patients
Question: We were preparing to report online E/M code 99444, but we learned that it's... Read more
Reader Question:
Keep HIPAA in Mind for Employee-Paid Tests
Question: When an employer pays our office to perform pulmonary tests, can we disclos... Read more
You Be the Coder:
Get Specific When Describing Pulmonary Function Tests
Question: If we perform pulmonary function tests (PFTs) and spirometry at the hospita... Read more
Compliance:
Tighten Your Pulmonologist's E/M Selection to Avoid Landing on CMS' List of Errors
Plus: Pulmonologists logged high error rates when billing subsequent hospital care. Becau... Read more
Check out CMS' Review Criteria
CMS identified a total of $28.9 billion in total improper payments among providers sampled... Read more
Diagnosis Coding:
Seeing COPD Patients? Consider These 5 Important Tips
Hint: Signs and symptoms codes might suit some cases best. Chronic obstructive pulmonary ... Read more
Patient Privacy:
Plan to Keep Patient Information Secure in 2020 With 7 Quick Tips
Hint: In some cases, you may have to consult an expert. As your pulmonology practice gets... Read more
Reader Question:
Quell Billing Woes for SNF Patients
Question: We saw a patient last month to treat her for emphysema and we didn't realize she... Read more
Reader Question:
Get the Scoop on Bilateral Modifiers
Question: Our pulmonologist biopsied the bronchioalveolar regions of a patient's left and ... Read more
You Be the Coder:
Identify Tests Used for Cystic Fibrosis Dx
Question: We just saw a patient with cystic fibrosis (CF) and the physician performed a pa... Read more
Test Yourself:
Can You Code This Respiratory Distress Encounter?
Read the medical note and determine which codes you would report. Sometimes it can be cha... Read more
Virtual Care:
Check These Best Practices for Billing Telehealth Services
Hint: Not every patient will be eligible for these services. Most pulmonology practices h... Read more
Reader Question:
Is This Patient New?
Question: We know a new patient is one that our pulmonologist hasn't seen in the past thre... Read more
Reader Question:
Time Can Be Used to Determine Inpatient E/M Level
Question: Our physician saw a COPD patient in the hospital at the request of the hosp... Read more
Reader Question:
Look to 95803 for Actigraphy Tests
Question: Our pulmonologist used actigraphy to evaluate an asthma patient for sleep d... Read more
Reader Question:
Here's What to Collect for Stored Credit Cards
Question: We recently had a consultant come in to evaluate our accounts receivables a... Read more
You Be the Coder:
Are E/M Changes on the Horizon?
Question: We have heard conflicting reports about whether big changes are coming to E/M pa... Read more
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