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Pulmonology Coding Alert

CPT 2008:
Latest Code Book Ushers in New Thoracentesis, Counseling Code Sets
Water seal now included in tube thoracostomy Before you report a thoracentesis procedure ... Read more
CPT 2008:
Solid Counseling/Care Coordination Notes Needed for New Nursing Codes
CPT scraps old definitions for 99304-99318 code family In addition to new codes for thora... Read more
Use This Guide to Sort Out Flu Vaccination Coding Questions
Code needle immunizations differently from intranasal ones 'Tis the season: Patients have... Read more
Reader Questions:
Leave Injection Code Off TB Test Claim
Question: When a patient reports to the pulmonologist for a pulmonary tuberculosis (TB) s... Read more
Reader Questions:
Yes, You Can Look Up NPI Information
Question: Is the NPI database up yet? I can't figure out where to look for it. Wyoming Su... Read more
Reader Questions:
Check for Diagnosis Before Coding Condition
Question: The pulmonologist treats a new patient with a chronic cough and abnormal sputum... Read more
You Be the Coder:
What Constitutes Separate E/M on Vaccinations?
Question: A 70-year-old established patient with commercial insurance reports to the pulm... Read more
Discover When -- and When Not -- to Report Diagnostic Bronchoscopy
31622 is often bundled into other bronchoscopy codesWhen coding diagnostic bronchoscopies,... Read more
Here's How to Get Paid for Office Visit With 95115, 95117
Medicare now allows same-day E/M service and allergy injection Before you write off anothe... Read more
READER QUESTIONS:
Counting Patients' Chronic Conditions
Question: The 1997 documentation guidelines state that I can achieve an extended history o... Read more
READER QUESTIONS:
5th ICD-9 Digit Can Affect Claim Acceptance
Question: When reporting an asthma diagnosis, do I need a fifth digit?North Carolina Subsc... Read more
READER QUESTIONS:
Bill 2nd Opinions 2 Ways
Question: I know that CPT deleted the confirmatory consult codes for billing second opinio... Read more
READER QUESTIONS:
Call On Add-on Codes for 2 Bronchoscopies
Question: Our physician performed a rigid bronchoscopy with lung biopsy on two lobes for a... Read more
READER QUESTIONS:
Medicare Approves Pay for More Moderate Sedation Scenarios
Question: What are Medicare's pay policies for the new moderate (conscious) sedation codes... Read more
You Be the Coder:
Choosing the Correct TBNA Code
Question: Our provider does a TBNA (transbronchial needle aspiration) with a Wang needle f... Read more
Look at Diagnosis, Payer to Code Kick-the-Habit Session
CPT to include smoking-cessation codes in 2008 Because no global rules exist for reporti... Read more
Get the Truth on 4 PQRI Myths
Reporting the voluntary measures might financially benefit your practice Before you let ... Read more
1 Do, 1 Don't Can Help You Dodge Critical Care Mistakes
Patient condition, not location, drives proper coding When your pulmonologist provides c... Read more
Reader Question:
Check Physician Involvement Before Coding Shot
Question: An established patient with intrinsic asthma comes to the office for an evaluat... Read more
Reader Question:
ABN May Be Necessary on Spirogram Screen
Question: We're being asked to perform screening spirograms on patients under considerat... Read more
Reader Question:
Remember Supervision Requirements for NPs
Question: If a nurse practitioner (NP) or physician assistant (PA) performs a diagnostic ... Read more
Reader Question:
Document All Physician Activities During CPO Service
Question: When the pulmonologist performs monthly care plan oversight (CPO) for a Medicar... Read more
You Be the Coder:
Patients With Emphysema Symptoms
Question: During an initial consultation with a new patient complaining of wheezing and ... Read more
Get the Lowdown on the Elimination of Albuterol, Levalbuterol J Codes
You can still get paid for noncompounded solutions, but you'll need to switch to Q codes ... Read more
Beware:
Private Payers May Still Accept J7611-J7614
Clip and save your inhalation solution coding guide You can get paid for albuterol and l... Read more
Share the E/M Work, Enjoy Full E/M Payment
Physician must see the patient if there's a new problem Judiciously using shared visits ... Read more
Make Shared Visits Work for Your Practice
You can financially benefit from NPPs in the hospital You can use Medicare's shared-visi... Read more
Reader Questions:
Fiberscope Is Key Component of 31725
Question: Code manager describes 31725 as "therapeutic aspiration of the trachea or bronc... Read more
Reader Questions:
Classify Pulm Rehab as E/M Service
Question: Our critical access hospital would like to set up a pulmonary rehab program. Wh... Read more
Reader Questions:
How to Audit Sleep Behavior Charts
Question: I want to audit our new sleep behavioral psychologist charts. How different is ... Read more
Reader Questions:
Biopsy and Brushing: 1 Code or 2?
Question: The patient is a 74-year-old man with a history of heavy smoking, with bilatera... Read more
Reader Questions:
Look for This Critical Care Criteria
Question: When a pulmonologist provides care to a critically ill patient, can I always us... Read more
You Be the Coder:
Post-Transplant Condition
Question: How should I code the following chart note: History: The patient is a 42-year-o... Read more
Specify Septic Embolism for the 1st Time Using New Circulatory Codes
CD-9 2008 will give you one more choice in the commonly reported 415.1x subcategory When t... Read more
Stop Using the 'Loophole' to Bill 99215
CPT and CMS require medical necessity for all E/M visits If you are a victim of the "E/M ... Read more
Why Modifiers 76 and 77 Matter -- Even When They Don't
Avoid duplicate denials by identifying 94640, 32002 as repeats Medicare considers modifier... Read more
Reader Question ~ Rules Allow 2nd-Day Admit
Question: When a pulmonologist admits a patient from the office and doesn't provide the in... Read more
Reader Question ~ Compare 90779 for TPA to 90765
Question: When we report TPA infusions with an unlisted procedure, what code should we com... Read more
Reader Question ~ Solve Coding of Chemical Insertion
Question: What code should I assign for chemical pleurodesis? Rhode Island Subscriber Answ... Read more
Reader Question ~ Washings & Interventions:
How Many CPT Codes?
Question: A pulmonologist performed a bronchoscopy under fluoroscopic guidance. Prior to... Read more
You Be the Coder ~ Can You Sometimes Break Out 31622?
Question: A pulmonologist performs washings in the left upper lobe and bronchial alveolar ... Read more
Let 4 Rules Steer Your E/M Coding for Transitioned Patients
Pulmonologists usually assume care, negating a consult--but there are exceptionsFor E/M se... Read more
Use ICD-9 Rules to Avoid Denials, Unfound Labels
Signs and symptoms may sometimes be your best choiceChoosing the right CPT procedure code ... Read more
Get Your E/M Coding on the Straight and Narrow
Payers differ on body-system exam requirements for 99214If your summer goal is to submit a... Read more
READER QUESTIONS:
Include Diagnostic Study in 95811
Question: My pulmonologist performs only the interpretation component of sleep studies. I ... Read more
READER QUESTIONS:
Use 30.0 BMI as Cutoff for 278.01
Question: A pulmonologist diagnoses a patient who is to undergo treatment for obstructive ... Read more
READER QUESTIONS:
Code 2nd Line With Swan-Ganz
Question: A pulmonologist places a central line and a Swan-Ganz catheter. Should I bill fo... Read more
READER QUESTIONS:
Pre-Op and Post-Op--1 Consult or 2?
Question: A patient with chronic obstructive pulmonary disease (COPD) is scheduled for a l... Read more
READER QUESTIONS:
Don't Bill Separately for 94060 Puffs
Question: What J code should I report for the medication that we administer in the metered... Read more
You Be the Coder:
Are Additional Lobe Biopsies Codable?
Question: A patient has a perihilar 0.5-cm nodule in the right lower lobe and a 1.5-cm sub... Read more
Pay Attention to These Factors When Coding Observationue.
Find out if you're a 99217-99236 coding wizard worthy of an extra cup of java If you code ... Read more
Keep Your Observation Options Straight by Using Our Handy Chart
We break down the scenarios to get you the correct code Tackle coding observation services... Read more
Nail Down Pulmonary Diagnoses With These Tips
Hint: Focus on acute conditions, exacerbations The key to correctly reporting asthma, bron... Read more
Look for Keywords to Understand COPD
Physicians will base an initial COPD diagnosis on several factors, and the medical record ... Read more
Embrace Double-Dipping When You Can Justify It
CMS approves counting statement in HPI and ROS Myth: You can't use the same element for bo... Read more
Reader Questions:
Code Condition to Show Needed ECG
Question: A pulmonologist ordered an electrocardiogram during a routine physical for a 53-... Read more
Reader Questions:
Antigens: Should You Use 1 Line?
Question: How should I bill preparation of three separate 10-dose immunotherapy vials (usi... Read more
Reader Questions:
Let Reason Steer Attempted Line Coding
Question: When our pulmonologists attempt to put in a central line and have a problem, nec... Read more
Reader Questions:
Reject Modifier in Bronchoscopy Case
Question: A pulmonologist provides two hours of critical care with a bronchoscopy, chest t... Read more
You Be the Coder:
Capture Pleural Effusion Service/Procedure in 5 Steps
Question: Two weeks post lung transplant, a hospital inpatient has a high fever and elevat... Read more
Look for This $125+ Boosting Phrase in Diagnostic Scope Notes
Error averted: Drop 31575 when biopsy occurs Reporting 31575 when your pulmonologist actu... Read more
6 Tips Keep Your Inpatient E/M Coding On The Up-And-Up
Medicare overspends millions on upcoded inpatient visits Carriers are scrutinizing your i... Read more
OIG Is Watching Your Doctor's Nursing Home Visits
Part B payments 'vulnerable to fraud,' watchdog says Nursing homes could be hotbeds of i... Read more
Prove Patient Is 'Critical' When You Report 99291
CPT considers many services part of the critical care package When deciding whether y... Read more
Reader Question:
You Can Refer to MD-Owned Sleep Lab
Question: We are a pulmonology clinic plus a sleep lab with two beds, and we bill for bot... Read more
Reader Question:
Stick With Nonspecific Code for MIPs & MEPs
Question: What is the correct way to bill for maximum inspiratory pressures (MIPs) and ma... Read more
Reader Question:
Must You Always Follow NCCI Edits?
Question: When specialty society guidelines differ from National Correct Coding Initiativ... Read more
Reader Question:
Report Bilateral 32002 on One Line
Question: I submitted documentation with a line-itemized claim for three same-day service... Read more
Reader Question:
Look Beyond HPI for Chronic Condition:
Question: The 1997 audit guidelines state that I can reach an extended history by updatin... Read more
Reader Questions:
Use This Diagnosis for Asthma With Croup
Question: An established patient with a history of asthma who is now taking Albuterol pr... Read more
You Be the Coder:
How to Weigh Vent Management Vs. E/M
Question: A pulmonologist visits a patient with acute respiratory failure in the medical... Read more
Get the Inside Scoop on Omalizumab Administration Coding
2 societies say Xolair falls under 90772If 90772 and 96401 came with a drug reference guid... Read more
Avoid Underreporting Your Omalizumab Services With 4 Items
You code it: Asthma patient receives omalizumab injectionA completed CMS-1500 form for adm... Read more
5 Steps Help You Pinpoint the Right Flu Shot Code Every Time
CMS changed the rules for flu-shot diagnoses -- get the details belowFlu season is under w... Read more
Reader Question:
Look at Total Time When Selecting 99238-9
Question: Some discharge claims contain 99238, and others list 99239. Which is correct?Ohi... Read more
Reader Question:
Give Dual Credit for ECG Order and Review
Question: The Marshfield Clinic's audit tool awards two credits for independent visualizat... Read more
Reader Question:
Report 041.11 Without Site
Question: What is MRSA sepsis, and how should I code it?Kentucky SubscriberAnswer: "MRSA" ... Read more
Reader Question:
Distinguish Between Laryngoscopies
Question: What is the difference between a direct and indirect laryngoscope?Connecticut Su... Read more
Reader Question:
Add a 5th Digit to Your Rhinorrhea Dx
Question: What diagnosis should I use for rhinorrhea?New York SubscriberAnswer: Effective ... Read more
Reader Question:
NPPs Can Share Certain Hospital Visits
Question: Can an initial hospital visit be split or shared?Michigan SubscriberAnswer: You ... Read more
You Be the Coder:
Solve 94640 Denial Using These Tools
Solve 94640 Denial Using These ToolsQuestion: I reported a sick visit in which a strep tes... Read more
Breathe Easy When You Code EAA Workup Using These Steps
Hint: 94010, 94375 are shoe-ins for bundled status A workup for possible extrinsic allergi... Read more
Welcome 2 Changes to Allergy Test Code
Thank CMS for increased antigen payment and quantity The next time you report allergy titr... Read more
E/M CODING ~ How to Make Sure Your 99214s Measure Up
Look for more detailed statements, extra elements You can't rely on the number of organ sy... Read more
Get Your NPI Now
Implementation may take up to 120 days, CMS says Time is running out to obtain your nation... Read more
CORRECTION ~ Mark 94644, 94645 as New Continuous Inhalation Codes
Double-check that you added 94644 and 94645 on your encounter sheets as the newly created ... Read more
READER QUESTION ~ Does Incident-to Apply to Inpatients?
Question: Can a nonphysician practitioner (NPP) report a consultation that she performs on... Read more
READER QUESTION ~ 6MWT Doesn't Require Spirometry
Question: Our pulmonologist started ordering six-minute walk tests. He doesn't do the pre-... Read more
READER QUESTION ~ Roll Same-Day OV Into Direct Admit
Question: Can we charge an office visit and admit on the same day if the physician sees th... Read more
READER QUESTION ~ Compare 2007 to 2006 Rates With This Tool
Question: What conversion factor is in effect for 2007?New Jersey Subscriber Answer: 37.89... Read more
READER QUESTION ~ Help CMS Form 1 Pulmonary Rehab Policy
Question: Does CMS have a national coverage determination on pulmonary rehabilitation?Cali... Read more
READER QUESTION ~ No Inpatient Direct Contact = No E/M Service
Question: The January 2007 Pulmonology Coding Alert "Reader Question: Bill 99238-99239 Whe... Read more
YOU BE THE CODER ~ Apply Endoscopy Rule to 31622
Question: A pulmonologist performs a fiberoptic bronchoscope and notes: "The entire transb... Read more
Chase Away the Winter Blues With More Money for E/M Services
Watch out: 2007 fee schedule cuts $750 from 31730 to prevent double-billing You'll re... Read more
Patient May Be New to You -- But Not to Medicare
Check your billing records for tax IDs, past visits Myth: If your pulmonologist hasn't see... Read more
Is the Patient New? Answer Correctly Every Time
These 5 questions pinpoint patient's statusTake the AMA's advice and answer these five que... Read more
CODING QUIZ:
Take 5 Minutes to Test Your NPP Coding Skills
Can you bill incident-to when NPP requests consult? Answer may surprise you You might thi... Read more
READER QUESTION:
Bill 94762 for the Equipment
Question: When a pulmonologist performs 94762 on hospital inpatients, may I bill for the c... Read more
READER QUESTION:
Use Modifier to Report Inhalations
Question: When I bill two units of 94640, insurers deny the second charge as duplicative. ... Read more
READER QUESTION:
Click Your Way to Bronchodilation Updates
Question: I have a report of a patient with documented asthma and shortness of breath, and... Read more
READER QUESTION:
How to Bill Patient-Requested Opinions
Question: I know that CPT deleted the confirmatory consult codes for billing second opinio... Read more
READER QUESTION:
Emphysema May Require Several Codes
Question: Which CPT code should we report when an established patient with emphysema (492.... Read more
READER QUESTION:
Roll 2 Same-Day Visits Into 1
Question: If a pulmonologist sees a patient in the morning for one problem and sees him ag... Read more
YOU BE THE CODER:
CPAP + Hosp Care: 1 Code or 2?
Question: A pulmonologist performed CPAP (94660) in addition to 99233. Should I separately... Read more
Get the Lowdown on CPT's Overhaul of the Pulmonary Subset
Respiratory care departments: New codes 94644-94645 also apply to you Your ventilator codi... Read more
Revel in the Plethora of Pulmonary Codes Coming Your Way This Winter
CPT 2007 adds 1 respiratory system code, 11 pulmonary codes and 1 allergy code Start marki... Read more
IMPROVE YOUR ACCURACY:
Report Post-op Critical Care Separately
The keys are ICD-9 codes, time-based documentation When a patient becomes critically ill o... Read more
READER QUESTION:
Try Billing PFT + E/M Without 25
Question: A patient comes in for a consult that an internist requested based on the pati... Read more
READER QUESTION:
Code Each DOS for Observation Days
Question: A pulmonologist coded a patient's hospital charges as one admission, two subsequ... Read more
READER QUESTION:
Follow 3 Rules When Coding 31632
Question: A pulmonologist performs one trans-bronchial biopsy in the right-upper lobe, two... Read more
READER QUESTION:
Use E/M for Trach Tube Change
Question: One of the patients in our rehabilitation hospital developed a problem with his ... Read more
READER QUESTION:
Allergy Testing--95024 vs 95027
Question: What is the difference between 95024 and 95027 for skin testing?Kentucky Subscri... Read more
READER QUESTION:
1 or 2 Sides Doesn't Affect 32491 Coding
Question: A thoracic surgeon performs bilateral lung volume reduction. What code should I ... Read more
YOU BE THE CODER:
Do 99238-9 Require Face-to-Face?
Question: A pulmonologist coded a patient's hospital charges as one admission, two subsequ... Read more