Medical Billing for Pulmonary

Medical Billing for Pulmonary Procedures

MPMR provides medical billing to pulmonary practices, with experts in the coding of pulmonology procedures. This includes office procedures, visits and hospital procedures for pulmonary as well.Medical Billing Pulmonary

During the medical billing process, insurance companies are billed by healthcare providers for certain healthcare services and procedures. Procedures and diagnoses have their own separate codes so that health management organizations (HMOs) can distinguish between the two as they are billed differently.

Procedures use a coding method set by the ICD-10, which uses a system of seven alphanumeric characters to correspond to different aspects of the procedure to specify what it is. The pattern and order of the characters does not change specialty to specialty, but the characters themselves change.

Character Order in Pulmonary Coding

Character 1: Section-the medical area under which the procedure falls

Character 2: Body System-the system of the body on which the procedure is being performed

Character 3: Root Operation-the basic operation or procedure that is being performedPulmonary Medical Billing company

Character 4: Body Part-the specific part of the body on which the procedure is being performed

Character 5: Approach-how the procedure is being performed (i.e. open, percutaneous, endoscopic, etc.)

Character 6: Device-any instruments, which are used specifically for the procedure (i.e. monitoring devices, insertion devices, and more).

Character 7: Qualifier-any other important information that would distinguish the procedure from similar ones.

Billing for Pulmonary Procedures

For pulmonary procedures, the billing code begins with “0B,” which shows that it falls into the Medical and Surgical section and the respiratory system. From there, the coding becomes specific to the procedures being performed.

For example, if a patient underwent a tracheostomy for any reason, that is if there was a breathing tube inserted into the patient’s trachea to aid in breathing, the billing code would be 0B110F4. The “0” marks that the section under which the procedure falls is the Medical and Pulmonology Billing CompanySurgical section. The “B” denotes that the procedure affects the respiratory system. The “1” notes that the root operation is a bypass operation.

A bypass operation applies to any procedure that bypasses a function of the body; in this case the procedure is bypassing a patient’s ability to breathe normally. The next “1” indicates that procedure is being performed on the trachea, which is the area of a person’s body that aids in breathing. The “0” shows the approach to the procedure is an open one.

An open approach to a procedure is when the skin would be cut in order to reveal the site area of the procedure more easily. It differs from the other approaches slightly, so it must be Medical Billing for Pulmonarydenoted using a different code.

The “F” shows that the device being used in the procedure is a tracheostomy device. A tracheostomy device is a device that is inserted into the trachea in order to aid in breathing. The “4” acts as the qualifier, indicating that the area to which the bypass goes is the cutaneous area rather than another area of the body, which would then have to be denoted using a different code.

It is important to recognize that the coding listed above is merely for single procedures. If there are combination procedures, those are coded separately. For example, if during a tracheostomy the patient also needed something else, the codes would be different. With combination procedures, it is necessary to use multiple codes depending on the objective of each procedure. Use a different code when the objective changes.

Conclusions

Medical billing procedures simplify and create a uniform system that can be translated by computer into the proper costs for each aspect of a procedure. In the ICD-10, the billing codes Medical Billing Neurologyare internationally recognized despite any differences is the medical practices in respective countries.

This way, there is an organized and streamlined method to billing for specific procedures across the board that allows insurance companies to be billed correctly for any procedures performed on a patient.

When it comes to pulmonary doctors, mistakes with ICD-10 coding can mean losses of tens of thousands of dollars. Let MPMR’s expert coders work with your pulmonary practice to increase revenue and increase efficiencies at the practice. In addition, MPMR offers expert credentialing and contracting as well!

Resources

http://www.icd10data.com/ICD10PCS/Codes/0/B

http://highered.mcgraw-hill.com/sites/dl/free/0073402036/639219/Chapter01.pdf

http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_044956.hcsp?dDocName=bok1_044956

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