Question:
What codes should be used to report outpatient respiratory rehab services that respiratory therapists provide?
Answer:
The following HCPCS level II codes are available for these services under certain conditions:
| G0237 | Therapeutic procedures to increase strength or endurance of respiratory muscles, face-to-face, one-on-one, each 15 minutes (includes monitoring) |
| G0238 | Therapeutic procedures to improve respiratory function, other than ones described in G0237, one-on-one, face-to-face, per 15 minutes (includes monitoring) |
| G0239 | Therapeutic procedures to improve respiratory function, other than services described by G0237, two or more |
These codes describe respiratory rehab services for respiratory therapy rehab (RTR). The services must, of course, be medically reasonable and necessary and prescribed by a physician for the assessment, diagnostic evaluation, treatment, management, and monitoring of patients with deficiencies and abnormalities of cardiopulmonary function. These HCPCS codes apply when a patient does not meet the chronic obstructive pulmonary disease (COPD) criteria set forth by Medicare, and the RTR should only be provided in the outpatient departments of acute hospitals or in a comprehensive outpatient rehab facility (CORF).
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.
CPT® copyright 2024 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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