Separate bronchoscopy codes 31626 and 31643 from each other.
In case your practice is huge on offering pulmonary function testing, make certain to look out for the latest Correct Coding Initiative (CCI) edits version 17.2. Edited bundles linked to pulmonary stress test (PST), bronchospasm evaluation, as well as spirometric recording emerge in the nonmutually exclusive section of the latest version, including some sleep testing procedures.
In CCI Edits 2011, three out of 322 commonly exclusive (ME) pairs are for pulmonologists, whereas nonmutually exclusive (NME) edits contain 41 out of 2,021 bundles from pulmonologyrelated procedures.
PST Overrules Expiratory Flow Measurement
CCI Edits 2011 feature 41 nonmutually exclusive pairs that are likely to impact pulmonologists. Nonmutually exclusive edits are applicable to services that a doctor may conduct during the same encounter, but that are not billable together. These edits are certainly nonbillable as one of the codes (the component code) is incorporated in the services that are represented by the second, larger (comprehensive) code of the pairing.
Exception: As per CCI Edits 2011, you can still bill individual components provided the doctor doesn't perform the whole comprehensive procedure. Though, in case the doctor performs the entire (comprehensive) procedure, you must bill just the comprehensive code.
Pulmonology-related NME bundles in CCI Edits 2011 include comprehensive services carried out by physicians as part of pulmonary function test. They are:
94621 (Pulmonary stress testing; complex [including measurements of CO2 production, O2 uptake, and electrocardiographic recordings]) paired with components 94011 (Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age), as well as 94012 (Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age)
94620 (Pulmonary stress testing; simple [e.g., 6-minute walk test, prolonged exercise test for bronchospasm with pre- and post-spirometry and oximetry]) including 94011 as well as 94012
94070 (Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, vadministered agents [e.g., antigen[s], cold air, methacholine]) including 94011 and 94012
94060 (Bronchodilation responsiveness, spirometry as in 94010, pre- as well as post-bronchodilator administration) including 94011 and 94012
94014 (Patient-initiated spirometric recording per 30-day period of time; with reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and physician review and interpretation), as well as 94015 ( . . . recording [includes hook-up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration]) including 94011
94012 along with 94200 (Maximum breathing capacity, maximal voluntary ventilation), 94375 (Respiratory flow volume loop), 96360 (Intravenous infusion, hydration; initial, 31 minutes to 1 hour), 96365 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; initial, up to 1 hour), as well as therapeutic, prophylactic, or diagnostic injection codes 96372-96376
94011 with 94200 as well as 94375.
Click here to know more about the CCI Edits 2011 and read the whole article for more accurate and profitable expert Medical coding advice: http://www.supercoder.com/articles/articles-alerts/puc/cci-edits-17.2-what-role-do-94011-94012-play-on-complex-pulmonary-stress-test-coding-107569/
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