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Medical billing and coding for Pulmonology practices can be complex.
Choosing an experienced medical billing company company in this unique specialty can help drive higher revenue. Every patient encounter needs to be accurately documented, coded, billed, and collected. The high deductible world of medicine also mandates an efficient yet patient friendly system for verifying insurance coverage and collecting patient responsibility balances both up front and after insurance has paid.
Etransmedia’s team of certified coders have the kind of experience necessary to ensure your Pulmonology practice will maintain consistent cash flow while increasing collection rates. All of our coders are certified either through the AAPC or AHIMA and uphold the ethics and standards of the profession. Additionally, our billers and coders work with your staff to learn the nuances of your practice so as to be aware of known issues. They will provide feedback on coding scenarios that need attention and possible correction.
What we know…
Pulmonology requires an array of tests needed to simply diagnose. Choosing a test to conduct requires noting necessity yet knowing what will be covered.
Diseases and conditions treated by Pulmonologists:
ARDS (acute respiratory distress syndrome),
COPD (chronic obstructive pulmonary disease),
Interstitial lung disease,
Occupational lung disease,
Sarcoidosis of the lungs,
SARS (severe acute respiratory syndrome).
Here are some of the complications that are affecting Pulmonology revenue collection procedure:
Included in Office Visits
Office Visits will need modifier GT
94060 (bronchodilation) add 59 when billed with other procedures
94010 (spirometry) add 59 when billed with other procedures
94620 (6 min walk) add 59 when billed with other procedures
Smoking Cessation (99406/99407) – Not Billable
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On October 1, 2016 the Centers for Medicare and Medicaid Services (CMS) will no longer accept unspecified codes in most cases.
Starting in October, CMS requires greater specificity for claims filed in ICD-10-CM/PCS. The 12-month grace period originally introduced in 2015 said they would not deny claims for lack of ICD-10 specificity. That all changes on October 1, 2016. Payors will most likely follow suit if they haven't already.
First Pass Clean Claim Rate
Boost in Revenue*
Reduction in Cost*
We’re always on top of all the latest coding and billing updates for Pulmonology practices.
Additionally, to make sure all claims are reimbursed on the first claim submission, our system is able to pre-edit claims prior to the initial submission for possible billing/coding errors. Our detailed end of month reports keep our clients up-to-date of what is happening in their practice so that any issues can be addressed quickly. The outcome of these processes and more is our clients have a streamlined revenue cycle with increased collection rates.
Although the new industry standards can be confusing and difficult to navigate, our dedicated team here at Etransmedia can assist in guiding you and helping to make your practice grow successfully.
*Please Note: Results are not guaranteed, implicitly or explicitly, and will vary based on several factors such as individual practice demographics, specialty, payer mix, operations, and management among others
Service and Technology Packages
Our customizable revenue cycle management service and technology solution packages allow you to outsource based on the specific needs of your practice
Silver RCM Service
This package has the core service and technology needed for revenue management allowing you maintain the responsibility of patient billing.
Gold RCM Service
This package includes the core RCM services with added denials, A/R management services, and full service patient billing
Ancillary RCM Services & Technology
Available to enhance any package