Pulmonology Coding Alert

READER QUESTIONS:

Shoot for Unlisted Procedure in MIPs, MEPs

Question: What code applies for MIP (maximal inspiratory pressure) and MEP (maximal expiratory pressure) when a pulmonologist performs the tests on a patient to measure his respiratory muscle strength? California Subscriber Answer: Usually, you would bill 94799 (Unlisted pulmonary service or procedure). Pulmonologists do MIP and MEP tests to measure a patient's respiratory muscle strength. However, CPT contains no specific code for the measurement of MIPs and MEPs. Catch: Check with your payer's policy for MIP/MEP billing to avoid unnecessary reimbursement hassles.When submitting a claim with an "unlisted" CPT code, be sure to include a description of the "unlisted" service on the claim form, as well as a reasonable fee for the service. Unlisted codes may represent many service types, and do not have a standard code description or fee associated with them. Be prepared to receive a request for documentation after initial claim submission. The payer will want to [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Pulmonology Coding Alert

View All