Pulmonology Coding Alert

Question: If our pulmonologist provided interpretation for blood gases that was performed in the laboratory, can this interpretation be reported separately or should it only be reported by the laboratory that is performing the test?

Georgia Subscriber

Answer: Usually, interpretations for blood gases will be provided by the laboratory facility that processes the specimen. In such a scenario, the laboratory will be reporting the procedure using the appropriate code i.e. 82800 (Gases, blood, pH only), 82803 (Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 [including calculated O2 saturation]), 82805 (Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 [including calculated O2 saturation]; with O2 saturation, by direct measurement, except pulse oximetry) or 82810 (Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry).

These codes are not subject to professional/technical components, and should only be billed by the entity that processes and analyzes the specimen. You should not report 82800, 82803, 82805 or 82810 (as the case may be) for interpretations provided by your pulmonologist. The interpretations provided by your pulmonologist will not be a separately reportable procedure but can be considered in the data review of the medical decision making component when selecting the visit level, as appropriate: 99201 (Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components....) -99215 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components...).