Coding for pulmonary services

August 28th, 2013 - Betsy Nicoletti
Categories:   Coding   Specialty Coding  
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This is an overview of billing for services provided by Pulmonologists.  Medicare recognizes Pulmonary Disease as a specialty.  The resources section of this article contains the E/M Frequency data from CMS for the latest year available, and the fifty most commonly billed CPT® codes.

What are the most common procedures: 

  • E/M services, including hospital visits and consults
  • Bronchoscopies
  • Critical care
  • Pulmonary function tests
  • Sleep studies
  • Medications (IM drugs) given during an office visit

Important coding issues:

  • Modifier use, including use of modifier 25
  • Payment rules for multiple procedures
  • Rules for critical care services
  • Professional and technical components of PFT's

A great resource is "Coding for Chest Medicine 2009" published by http://www.chestnet.org/practice/pm/index.php

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