Pulmonology Coding Alert

Question: How should I bill for a pulmonologist who goes to the hospital and reviews arterial blood gas (ABG) results for all of our group's patients?

California Subscriber Answer: Most Medicare and private payers will not reimburse practices for reviewing ABG results. If your pulmonologist withdrew the arterial blood sample, you could report 36600 (Arterial puncture, withdrawal of blood for diagnosis) or 36620 (Arterial catheterization or cannulation for sampling, monitoring or transfusion [separate procedure]; percutaneous), depending on the physician's method.

When the physician analyzes the specimen, you can assign 82800-82810, depending on the analytes the physician measured.

For instance, if the physician measured only gases and blood, you would use 82800 (Gases, blood, pH only). The analysis includes the processing of the specimen to determine the values of the analytes.

If a pulmonologist reviews the data produced from these tests, the physician can include this review as a part of the complexity of medical decision-making but should not bill separately for this service.