Don't Overlook 3 Key Coding Opportunities for Pulmonology Claims
Published on Fri Nov 20, 2009
You could be turning away your rightful reimbursement for scores of services. Medicare coding rules are complex and challenging, and sometimes it's difficult to know which services you can rightfully report. But if you're up to speed on these key coding practices, you'll be raking in deserved pay: 1. Mine those modifier 59 opportunities. Some coders assume that if the Correct Coding Initiative (CCI) forbids reporting two codes on the same date, that's the end of the story. But in fact, you may be missing out on some legitimate cases where CCI allows you to use modifier 59 (Distinct procedural service) to override an edit. Always scan the CCI edits to see which code pairs can be overridden when appropriate. Of course, you should use modifier 59 only when the services are separate, distinct, and medically necessary. Example: The need for separate pulmonary function testing (for instance, 94060, Bronchodilation responsiveness, [...]
