Pulmonology Coding Alert

Question: Our pulmonologist recently treated a patient with pulmonary symptoms such as dyspnea and severe non-productive cough attributed to Type 1 decompression sickness following a scuba diving incident. The patient also showed symptoms of joint pains, fatigue and peripheral edema. Our pulmonologist treated the patient with hyperbaric oxygen therapy to relieve the symptoms he was facing. I am confused whether to use C1300 or 99183 to report this procedure that our pulmonologist performed?

Florida Subscriber

Answer: The solution to your coding dilemma lies in identifying the location in which your pulmonologist performed the hyperbaric oxygen therapy and who is reporting the service. When the location is the outpatient department of a hospital facility, the facility reports C1300 (Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval) to report the hyperbaric oxygen that your pulmonologist used for treatment. This code is reported for every 30 minutes of therapy that your pulmonologist administered to the patient. Note that C-codes are used only as a part of Hospital Outpatient Prospective Payment System (OPPS) and cannot be used to report other services.

For the professional services associated with therapy, you can report your pulmonologist's services with 99183 (Physician attendance and supervision of hyperbaric oxygen therapy, per session). It is also important to note that your physician may also report any E/M services such as 99201-99205 (Office or other outpatient visit for the evaluation and management of a new patient...), 99211 -99215 (Office or other outpatient visit for the evaluation and management of an established patient...) or 99221-99223 (Initial hospital care, per day, for the evaluation and management of a patient...) if he evaluated/managed a condition apart from the hyperbaric oxygen therapy.

The documentation of the patient should include all the services that your pulmonologist provided to the patient including the response of the patient's symptoms to the therapy and complications, if any. It is also important to document the immediate availability of cardiopulmonary resuscitation measures in the chamber where the therapy was provided.