When providing inhalation treatment for acute airway obstruction, Medicare will not pay for both 94640 and 94644 if they are billed on the same day for the same patient. The coder must decide which of the two codes to submit for payment. Generally, it would be the code that has the greatest volume/quantity. Also, Medicare covers pulmonary rehabilitation programs for patients who have been diagnosed with moderate, severe, or very severe COPD as established by the GOLD guidelines. No more than two one-hour sessions may be billed in a single day and the services are only covered if provided in a physician’s office or hospital outpatient department.
Pulmonology medical billing is complex and ever-changing. Confronting declining payments, increasing patient responsibility and increased operational costs requires efficient and accurate medical billing procedures. Our team of certified medical coders and billing experts will manage all aspects of your medical billing, including common documentation shortfalls, which help to ensure your practice receives maximum compensation for services rendered.