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Pulmonology Coding Alert

CPT® 101:
Understand How to Fix 3 Common PFT Coding Mistakes
Hint: You need to show medical necessity for 94060. Pulmonology coders who are newly cred... Read more
Practice Management:
Keep Your Telehealth Program Compliant in a Post-PHE World
Remember: contracted vendors are also subject to HIPAA regulations. Now that we've turned... Read more
Billing Basics:
Nail Down NCCI Edits With This Expert Advice
Learn how to properly unbundle PTP edit pairs to ensure accurate coding. Coding software... Read more
You Be The Coder:
Know When to Correctly Append Modifier 51
Question: A patient diagnosed with cystic fibrosis required intrapulmonary surfactant admi... Read more
Reader Question:
Recognize How to Code Adenoviral Pneumonia
Question: A 3-year-old pediatric patient presented to a pulmonology practice with com... Read more
Reader Question:
Learn How to Report Bronchodilator Supply for 94060
Question: CPT® code 94060 includes bronchodilator administration, but can we bill th... Read more
Reader Question:
Choose the Correct Z-Code for RSV Administration
Question: I've noticed that the respiratory syncytial virus (RSV) vaccine CPT® code ... Read more
2024 CPT® Updates:
Get Ready for E/M and Vaccine Changes in 2024
Learn how COVID-19 codes have been consolidated. The AMA released the 2024 CPT® code set... Read more
ICD-10-CM:
Use These 5 Tips to Solidify Your COPD Coding Skills
Know how to report COPD and related conditions. Pulmonologists commonly see patients wit... Read more
Compliance:
Is Your Practice Accommodating to Deaf Patients?
Noncompliant practices face punishments from federal agencies. When deaf or hard-of-heari... Read more
Reader Questions:
Will Practices Wait on Time-Based Split/Shared Billing?
Question: I remember the Centers for Medicare & Medicaid Services (CMS) putting a... Read more
Reader Questions:
Choose the Correct Patient-Initiated Spirometry Service Code
Question: A pulmonologist in our practice provided a patient with an at-home spiromet... Read more
Reader Questions:
Report J00, Not Symptoms, When Dx Is Definitive
Question: A patient presented with symptoms of sneezing, stuffy and runny nose, cough... Read more
You Be the Coder:
Avoid Overthinking the E/M Elements of MDM
Question: A patient was referred to a pulmonologist from their primary care physician... Read more
Medicare Physician Fee Schedule:
Prepare for Possible E/M and SDoH Reporting Changes in 2024
Plus: Is a zero percent change a positive? Find out. The Centers for Medicare & Medi... Read more
Mythbusters:
Scan Code Descriptors to Bust These 3 PFT Myths
Learn how to report repeated PFTs on the same day. As a pulmonology coder, you know when... Read more
Recruitment:
Pay Close Attention When Including AI in Your Hiring Process
Avoid unintentionally violating ADA, Title VII protections. Healthcare is experiencing a ... Read more
Reader Questions:
Analyze This Atelectasis Encounter
Question: I'm new to coding and I'm having trouble understanding a phrase on a medica... Read more
Reader Questions:
Pick out Primary Diagnosis Z Codes Easily
Question: I really enjoy the coding quizzes that test my knowledge. In Pulmonology Co... Read more
Reader Questions:
Sift Through the Confusion of the E/M MDM Table
Question: I always have trouble coding evaluation and management (E/M) visits. Recent... Read more
You Be the Coder:
Exercise Your Asthma Coding Skills With This Scenario
Question: A new patient visited a pulmonology practice after experiencing shortness o... Read more
ICD-10-CM 2024:
Prepare for 2024 Diagnoses With New BOS, CLAD, and SDOH Codes
Prime yourself before the codes take effect October 1. Pulmonology coders can look forwar... Read more
Guidelines:
Review Code Note Changes to Ensure Correct ICD-10-CM Coding
Avoid missing dollars by reviewing key coding notes. When the 2024 ICD-10-CM code set ta... Read more
E/M:
Refresh Your Incident-To Knowledge With the Answers to These 3 FAQs
Find out if incident-to always requires direct supervision. Billing for incident-to serv... Read more
Reader Questions:
Modify Your Claim to Indicate Separate Services
Question: A patient presented to our pulmonology clinic with an exacerbation of their... Read more
Reader Questions:
Find This Coding Needle in the ICD-10-CM Haystack
Question: I have a medical report where the physician diagnosed the patient with hay ... Read more
Reader Questions:
Know Who to Notify for a Data Breach
Question: We identified a small data breach in our system that impacted 115 patients.... Read more
You Be the Coder:
Examine This Pulmonary Edema ED Visit
Question: A patient visited our emergency department (ED) with complaints of coughing... Read more
ICD-10-CM:
Elevate Your Pleural Effusion Coding Skills
Pay attention to Code first notes. The pleura is the thin tissue that surrounds the lungs... Read more
Artificial Intelligence:
Evaluate Your Claims Before Submission by Adding AI to Your Revenue Cycle
Let AI handle simple coding cases to improve productivity. Healthcare has enjoyed a front... Read more
Modifier Mania:
Use Modifier 22 Properly to Avoid Triggering an Audit
Remember: modifier 22 is a request for additional payment. Modifier 22 (Increased procedu... Read more
Reader Questions:
Use 94640 to Report IPV Therapy
Question: I'm new to pulmonology coding and I have a pulmonologist's report that indicates... Read more
Reader Questions:
Hear This FDA RSV Vaccine Announcement
Question: Thank you for the respiratory syncytial virus (RSV) vaccine information provided... Read more
Reader Questions:
Append Modifier 91 for Repeat Tests
Question: I have a medical report where the pulmonologist listed the patient's diagnosis a... Read more
You Be the Coder:
Differentiate Between Pulmonary Nodules and Pulmonary Fibrosis
Question: I have a report where the provider diagnosed the patient with multiple pulmonary... Read more
Reimbursement:
Realize the Accurate Costs of PR Sessions for Your Practice
Learn how PR and CR reimbursement rates compare. Healthcare clinicians offer pulmonary re... Read more
Coding Quiz:
Put Your Postprocedural Respiratory Complication Coding Skills to the Test
Know how to report a cancelled procedure. Patients can develop several respiratory compli... Read more
Modifiers:
Decipher Cigna’s New Modifier 25 Payment Process
Prepare for a restrictive claims submission process. Cigna has proposed updating their p... Read more
Coding Quiz Answers:
Did You Ace Our Postprocedural Respiratory Complication Coding Quiz?
Were you able to identify the right VAP code? Think you really know your postprocedural... Read more
Reader Questions:
Use SDOH Codes When a Patient Doesn’t Fill a Script
Question: During a recent follow-up appointment with an established patient, the pati... Read more
Reader Questions:
Identify the Difference Between J70.2 and J70.4
Question: I have a report where the provider diagnosed the patient with immunotherapy... Read more
You Be the Coder:
Uncover the Code Needed for a Graphite Fibrosis Dx
Question: A 75-year-old new patient came into our pulmonology office complaining of a... Read more
Ventilator Coding:
Succeed Under Pressure With These CPAP and CNP Best Practices
Can you report CPAP and E/M codes together? Find out. Providers use positive airway pres... Read more
Compliance:
Bid Farewell to Certain HIPAA Flexibilities
Enjoy telehealth discretion as a compromise. You're likely in action to prepare your prac... Read more
ICD-10-CM:
Remember T Codes to Report Drug-Induced Interstitial Lung Disorders
Hint: Code symptoms until a diagnosis is made. Diagnosing drug-induced interstitial lung ... Read more
Reader Questions:
Check With Your Payer for Incentive Spirometer Instruction Claims
Question: One of our physician assistants instructed a patient on the correct use of... Read more
Reader Questions:
Understand Documentation Requirements for 94010
Question: I've recently transitioned to pulmonology coding, and I see a lot of spiro... Read more
Reader Questions:
Learn Which J Code is Right for Lung Scarring and Pulmonary Fibrosis
Question: I have two different medical encounters to code. The diagnosis for one is l... Read more
You Be the Coder:
Explore the Alphabetic Index to Find Your Tracheobronchitis Diagnosis
Question: A 46-year-old patient with a history of smoking visited our office and saw ... Read more
ICD-10-CM:
Allow Guidelines to Direct Your ARF Code Selection
Learn how to sequence respiratory failure codes. Acute respiratory failure (ARF) is a med... Read more
Billing Basics:
Clear Up Your Oximetry Coding Confusion With These 3 FAQs
Hint: Oximetry is bundled into an E/M visit. Ear or pulse oximetry is a vital procedure ... Read more
Post-PHE Changes:
Prepare Your Practice for the End of the Pandemic
Good news: Changes don't have to happen overnight. The end of the COVID-19 public health... Read more
Reader Questions:
Stay Professional to Report Sleep Study Results Interpretation
Question: A Medicare patient underwent a polysomnography at an outside facility, wher... Read more
Reader Questions:
Know What Separates J44.1 From J44.0
Question: A patient with mild intermittent asthma and chronic obstructive bronchitis... Read more
Reader Questions:
Examine U07.0 Descriptors to Code for EVALI
Question: A patient presented to our clinic complaining of cough, shortness of breat... Read more
You Be the Coder:
Code This CF Chest Physical Therapy Encounter
Question: During a follow-up appointment, a patient with cystic fibrosis received che... Read more
ICD-10-CM:
Bolster Your Simple and Mucopurulent Chronic Bronchitis Coding
Find out what separates the J41.- conditions. If a pulmonologist's report describes a pat... Read more
Mythbusters:
Discover the Truth About PFT Component Code Misconceptions
Hint: You can report 94150 and 94200 separately. As a pulmonology coder, you think you c... Read more
E/M:
Elevate Your Data Counting Skills With 3 Helpful Hints
Plus, know when to press pause on counting data. As a pulmonology coder, having a strong ... Read more
Reader Questions:
Investigate the Documentation and Guidelines to Code a VAP Case Correctly
Question: A patient was admitted to the hospital with pneumonia due to streptococcus... Read more
Reader Questions:
Use Appendix T to Report Smoking Cessation Counseling Phone Calls
Question: Since the start of the new year, several of our patients are seeking smokin... Read more
Reader Questions:
Know the Criteria for Receiving a CBR
Question: I enjoyed your article, “Are You Billing Bronchodilator Nebulizer Medica... Read more
You Be the Coder:
Dive Into Documentation to Choose Between 31622 and 31624
Question: I have a procedure note in which the pulmonologist wrote that during a bron... Read more
CPT® 101:
Be Confident Applying +94645 for Continuous Inhalation Treatments
Find out if 31 or 60 minutes is the magic number. When a pulmonologist initiates continu... Read more
Benchmarking:
Are You Billing Bronchodilator Nebulizer Medication More Than Others?
Remember that a CBR is an educational tool. A recent comparative billing report (CBR), co... Read more
Reimbursement:
Congress Seeks a CF Peace Offering With the CAA, 2023
Find out which telehealth flexibilities are extended again. When the Centers for Medicare... Read more
You Be the Coder:
Code This Asthma E/M Encounter Correctly
Question: The pulmonologist in our practice saw an established patient who was experi... Read more
Reader Questions:
Wait for FDA Approval Before Reporting RSV Vaccine Administration
Question: I was reviewing my 2023 CPT® code set and noticed there is a new code des... Read more
Reader Questions:
Warm Up Your Cold-Induced Asthma Diagnosis Coding
Question: A patient was referred to our pulmonology practice by their general practi... Read more
Reader Questions:
Remember Minimum/Maximum Length for Actigraphy Tests
Question: I have a report where the pulmonologist used actigraphy to evaluate a patie... Read more
Coding 101:
Keep Your Ventilator Management Claims Compliant With These 3 Tips
Learn the rules for vent management and E/M coding. Assigning the correct ventilation man... Read more
Reimbursement:
Can You Report 31645 for Multiple Outpatient Therapeutic Aspirations? Find Out
Recognize the restrictions of a DOS edit. Occasionally, a medical report will come across... Read more
Nerve Stimulation:
Correctly Code Neurostimulator Use For Patients With Sleep Apnea
Patients who fail CPAP may be excellent candidates for this cutting-edge service. Some p... Read more
Reader Question:
Are New Patients Billable as Incident To?
Question: During a new patient encounter, the nurse practitioner (NP) documented the ... Read more
Reader Question:
Sift Through SDOH Codes to Report Patient Noncompliance
Question: A patient came in for a follow-up evaluation and management (E/M) visit for... Read more
Reader Question:
Check Your State Laws for HIPAA Expiration Requirements
Question: Our patient forms pertaining to HIPAA have an expiration date of one year f... Read more
You Be the Coder:
Understand What ‘Diagnostic’ Means for Bronchoscopies
Question: AMA CPT® guidelines state, “Surgical bronchoscopy always includes diagno... Read more
Physician Fee Schedule:
Learn If CMS Adjusted the CY 2023 Conversion Factor
 What defines substantive portion of split/shared billing in 2023? When the Centers ... Read more
Coding Quiz:
Put Your Pulmonology Diagnosis Coding Changes Memory to the Test
Do you remember the big ICD-10-CM changes for the 2023 code set? Every year is full of co... Read more
E/M Coding:
Stay Out of Auditors’ Crosshairs by Correctly Coding Time-Based Visits
Make sure you don't bill a service twice. Using total time to level an evaluation and man... Read more
Coding Quiz Answers:
Check Your Answers to Our 2023 ICD-10-CM Coding Quiz
Think you mastered the updates? Find out! Check your work to see if your answers from the... Read more
Reader Question:
Modify Your Bilateral Lesion Destruction Coding Knowledge
Question: I have a report that documents a bilateral lesion destruction via laryngoscopy. ... Read more
Reader Question:
Is Z28.311 Necessary for Vaccine Administration Encounters?
Question: Several patients have come into our practice for their annual flu vaccines.... Read more
Reader Question:
Pay Attention to Parenthetical Notes When Coding CPET
Question: I have documentation stating the physician performed cardio­pulmonary exercise ... Read more
You Be the Coder:
Correctly Code This Follow-Up E/M Visit With Spirometry
Question: An established patient recently visited our pulmonology practice for a foll... Read more
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