tci Part B Insider - 2014 Issue 39

Pulmonology Coding: Let CMS's Vent Management Rules Guide Your Code Selections

Documentation determines choice between E/M and ventilation management coding. You may be missing out on deserved reimbursement dollars for your pulmonologist’s respiratory failure treatments if you do not pay attention to the method of ventilation management, location of care, and Medicare’s rules regarding E/M codes and critical care services. Here’s a lowdown on how to choose the right ventilation management code to decrease your claim denials while getting the most payment for performed services. 1. Make a choice between E/M and Ventilator Management If your pulmonologist has been called to a critical care unit and she...

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