Pulmonology Coding Alert
When Does Moderate Sedation Fit?
Question: The pulmonologist performs a scheduled flexible bronchoscopy on an established 64-year-old patient. The physician takes transbronchial lung biopsies from two lobes. The patient feels some pain, and gets nervous, so the pulmonologist decides to provide 26 minutes of moderate sedation during the procedure. Is it appropriate to report the sedation separately? Nevada Subscriber Answer: No. You cannot report the moderate sedation (99144, Moderate sedation services [other than those services described by codes 00100-01999] provided by the same physician performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; age 5 years or older, first 30 minutes intra-service time) separately. Remember that moderate sedation is bundled into many of the bronchoscopy codes. Tip: In the scenario given, you should report the following: 31628 (Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; with transbronchial lung biopsy[s], single lobe) for the bronchoscopy with transbronchial lung biopsies of the first lobe. +31632 (... with transbronchial lung biopsy[s], each additional lobe [list separately in addition to code for primary procedure]) for the transbronchial lung biopsies of the second lobe.
Pulmonology Coding Alert
- Sleep Study:
3 Tips Accelerate Your Actigraphy Coding Claims
Leaving off this key modifier could mean a disaster.Last year, you saw the introduction of [...] - ICD-9 Coding:
Heed These 3 Essential Warnings When Using E-Codes
Find out how E codes help insurance companies on injury prevention and safety issues.If you [...] - Modifiers:
Test Yourself with Real-Life Modifier 25 Scenarios
Do you have the same coding conclusions as our experts?As you may already know, you [...] - Check Out This Pulmonolgy-Specific Modifier 25 Example
Your pulmonologist sees Mrs. Jones in the office and gives her a nebulizer treatment in [...] - You Be the Coder:
Don't Confuse 96401 with 96372 for Xolair Administration
Question:We just gave our first Xolair injection recently. The patient had the drug shipped to [...] - Reader Questions:
Conditions Bind Billing E/M, Procedure on the Same Day
Question:Can you, at any time during an outpatient bronchoscopy, bill an E/M outside of a [...] - Reader Questions:
Avoid 2 Pulmonologist Reporting Same-Day Critical Care
Question:A pulmonologist in our practice saw a patient in the morning for critical care. In [...] - Reader Questions:
Include As Many Bronchoscopy Codes -- If Necessary
Question:Codes 31628, 31624, and 31624 are all for bronchoscopy procedures. Will payers deny our claim [...] - Reader Questions:
Follow PQRI Rules to the Letter
Question:Does e-prescribing require entry of all of a patient's medications into an electronic system? Isn't [...] - Reader Questions:
Focus on Single Diagnosis During E/M Encounter
Question:My pulmonologist sees an established patient who complains of trouble in breathing, and frequent coughing. [...] - Reader Questions:
When Does Moderate Sedation Fit?
Question:The pulmonologist performs a scheduled flexible bronchoscopy on an established 64-year-old patient. The physician takes [...] - Reader Question:
Make COPD Diagnosis Codes Work to Your Advantage
Question:My pulmonologist documents both COPD and acute bronchitis for a patient who presented in our [...]
