Pulmonology Coding Alert

Other E/M and respiratory codes you may use appear frequently in column 2 of the Correct Coding Initiatives (CCI) 15.2 edits, but the good news is they aren't likely to rock your boat too much.

Among the most frequently appearing codes in column two were 99315 (Nursing facility discharge services), 99234-99236 (Observation or inpatient hospital care), and 99239 (Hospital discharge services).

These are now bundled with a host of 00xxx and 01xxx anesthesia administration codes.

Since pulmonology practices do not often use anesthesia, nursing home discharge, or observation care codes, the bundling of these pairs will probably not create much of a problem, notes Alan L. Plummer, MD, professor of medicine in the division of pulmonary, allergy, and critical care at Emory University School of Medicine in Atlanta.

Also, a range of 94xxx pulmonary codes are now bundled with anesthesia codes 01920 (for cardiac catheterization), 01922 (for radiological procedures), and 01990 (for harvesting organs). This means, for instance, that a physician reporting one of the above anesthesia codes cannot also code for monitoring direct or indirect O2 inputs or CO2 outputs (94680-94720), giving positive or negative pressure ventilation (94660-94662), or performing oximetry (94760-94762), explains Plummer.

What it means: Anesthesiologists are more likely to feel the impact of these changes than pulmonologists, since these pulmonary monitoring services are considered now inclusive and integral to the anesthesia service, says Barbara J. Cobuzzi, MBA, CPC,CPC-H, CPCP, CENTC, CHCC, senior coder and auditor for The Coding Network and president of CRN Healthcare Solutions in Tinton Falls, N.J.