Pulmonology Coding Alert

Test yourself with these 5 questions about the edits, deletions, and additions If you’re still trying to get a grip on the changes from the Jan. 1 CPT changes, take this quiz. These questions will test just how well you understand the new conscious sedation and drug administration changes.  Look below the article to see the answers. Question 1: A 2-year-old patient undergoes a bronchoscopy. To minimize the child’s emotional trauma and to ensure complete safety during the procedure, your pulmonologist administers moderate sedation. How should you report this? A. 31622
B. 31622 and 99143
C. 31622 and 99144
D. 31622 and +99145 Question 2: True or false: You can never report conscious sedation with tube thoracostomy (32019, 32020). Question 3: An internist requests that your pulmonologist see a newly hospitalized patient with chronic obstructive bronchitis and a new right lower lobe (RLL) infiltrate accompanied by fever, cough and yellow sputum. The pulmonologist diagnoses pneumonia and on a different day during the same inpatient stay he checks on the patient and provides subsequent pulmonary care. Which of the following coding scenarios might be appropriate for reporting these visits in 2006? A. 99253 for the first visit and 99261 for the second
B. 99261 for the first visit and 99231 for the second
C. 99253 for the first visit and 99231 for the second
D. None of the above Question 4: A patient has an acute asthma attack and your pulmonologist orders an IV push of SoluMedrol. What code should you use? A. 90782
B. 90774
C. 90784
D. G0344 Question 5: A patient receives a subcutaneous injection of omalizumab (Xolair) under direct supervision of the physician. How should you report this using the new codes? A. 99211
B. 99211 and J2357
C. 90772
D. 90772 and J2357

Quick Quiz Answers Answer 1: A. You should report just the bronchoscopy procedure code, 31622 (Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; diagnostic, with or without cell washing [separate procedure]). Code 99143 (Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician performing the diagnostic or therapeutic service that the sedations support, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; under 5 years of age, first 30 minutes intra-service time) would be the appropriate conscious sedation (CS) code, but you’re not allowed to report CS with 31622. Code 31622 is a “targeted” code, according to Appendix G of CPT. This means that if the same physician performs the bronchoscopy procedure and provides the CS, you cannot [...]