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Inappropriate reporting of CPT®/HCPCS code groups. Incorrect billing for breathing treatments. Lack of documentation to support medical necessity. These are just a few of the myriad problem areas uncovered by our experts’ audits of respiratory therapy, pulmonary function testing, cardiopulmonary services, and sleep studies. The pandemic remains a trying time for healthcare leaving the financial health of many facilities on the brink.
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What is the significance of using the term “first hour” in CPT code 94644, and how does this differ from other time-based codes that use the term “up to 1 hour”?
When should code 95813 be reported during a sleep study, and what is the duration of monitoring that qualifies for this code?
What is the typical duration of a polysomnography (PSG) procedure as described by codes 95810 and 95811?
How does the presence of unit of service edits and medically unlikely edits impact the billing practices for code 94375, particularly regarding the flow volume loop as an alternate method of calculating standard spirometric parameters, and what considerations
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For Robin Miller Zweifel, there’s no mystery surrounding the uniqueness and perennial popularity of our respiratory therapy resources. She shares the backstory here.
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