Pulmonology Coding Alert

Question: My physician is beginning to do electronic downloading of patient information from a continuous positive airway pressure (CPAP) machine. Do you know what code we can use to report the download and the physician's interpretation of the results?


Kentucky Subscriber

Answer: The success of getting paid for such services is slim to none. Some private payers may allow you to report this service using 99090 (Analysis of clinical data stored in computers [e.g., ECGs, blood pressures, hemotologic data]) or 99091 (Collection and interpretation of physiologic data [e.g., ECG, blood pressure, glucose monitoring] digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified healthcare professional, requiring a minimum of 30 minutes of time), depending on the nature of the service and the time associated with it.

For Medicare and those carriers that follow Medicare guidelines, these codes are not payable under the Physician Fee Schedule. The  review services your physician provides are part of the pre-and/or post-service work associated with any evaluation and management services the patient undergoes.

Answers for You Be the Coder and Reader Questions were reviewed by Carol Pohlig, BSN, RN, CPC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia; and Alan L. Plummer, MD, professor of medicine, division of pulmonary, allergy, and critical care at Emory University School of Medicine in Atlanta.