Question:

Can the following level II code be used for non-COPD patients as well as COPD patients?

G0424 Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day

Answer:

You should assign G0424 only for chronic obstructive pulmonary disease (COPD) patients and not bill services for non-COPD patients. Medicare covers pulmonary rehabilitation items and services for patients with moderate to very severe COPD (defined as GOLD classification II, III, and IV), when referred by the physician treating the chronic respiratory disease.


This question was answered in the 2018 edition of our Coding Essentials for RT/Pulmonary Function. For more hot topics relating to respiratory therapy services, please visit our store or call us at 1.800.252.1578, ext. 2.

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