Compliance

Respiratory Question for the Week of April 1, 2024

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 should healthcare providers keep in mind to ensure proper reimbursement while adhering to CMS guidelines?

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Respiratory Question for the Week of March 25, 2024

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?

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Cardiology Question for the Week of March 18, 2024

How is the following scenario coded? A patient has an SVG anastomosed to the LC obtuse marginal (OM). Next, this graft “jumps” to the RC posterolateral branch. Through the vein graft, the OM lesion is treated with angioplasty and bare metal stenting and a second lesion in the posterolateral branch of the RC is treated with angioplasty and bare metal stenting.

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