Respiratory Question for the Week of March 25, 2024

Question:

How does the variability in normal ranges for breathing response to hypoxia impact the coding and billing process for related procedures, and what steps should healthcare facilities take to ensure proper reimbursement, particularly when dealing with Medicare or other payers?

Answer:

Definitive diagnosis is impaired due to a wide range of normal ranges, making interpretation difficult. In most cases, the procedures will be paid only on an individual basis after review and consideration of special documentation. Check with the Medicare Administrative Contractor (MAC) or other payer to determine coverage for your facility.

This question was answered in our Coding Essentials for RT/Pulmonary Function. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

TAGS: Compliance, CPT, Respiratory Therapy

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