Pulmonology Coding Alert

Question: We have recently started our pulmonary rehab department in our physician's clinic. Are we allowed to bill for education classes (6-8 patients per class) done by a nurse practitioner in addition to their normal pulmonary rehab visits? If so what CPT code would be applicable for these group classes?

Answer: Pulmonary rehabilitation program (G0424, Pulmonary rehabilitation, including exercise and monitoring, per hour, per session) is a physician-supervised program that includes physician-prescribed exercise, education and/or training, psychosocial assessment, and outcomes assessment. Education or training sessions can include respiratory techniques such as physical energy conservation, work simplification, relaxation, and smoking cessation. Additionally, education services should not overlap in topic or type of instruction with the educational services required as part of the pulmonary rehab services. Group services (98961, Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient [could include caregiver/family] each 30 minutes; 2-4 patients, and 98962, ...5-8 patients) are typically excluded from payer coverage, or considered bundled into the pre-and post-work of standard physician services.