MedLearn Coding Guide Resources

2020 Medicare Payment Guide for RT/Cardiopulmonary Services

Medicare Payment Guide for RT/Cardiopulmonary Services

What are the current payment rates for EKGs, stress tests, sleep studies and all the other respiratory therapy/cardiopulmonary procedures performed in your facility? Quickly find the answers
you need right here!

A time-saving pathway to essential payment information

Quite simply, this resource provides the easiest and fastest way to find the most up-to-date Medicare payment information for a full range of respiratory therapy and cardiopulmonary services — EKGs, stress tests, sleep studies and many more. Are you receiving the full payment for services rendered? Are you complying with all regulatory requirements? One convenient reference quickly delivers the answers you need!

Features and Benefits

  • Updated with NEW information
    • Payment changes with the most current conversion factors
    • Updated status indicators, including new and revised codes, code descriptions, coding guidelines and payments
  • Easy to navigate — typical procedures are mapped to ambulatory payment classifications (APCs), current reimbursements and status indicators
  • At-a-glance tables with crosswalks compare the prior year payment rate to the current rate
  • Key to status indicators at the bottom of every other page, guiding you through Medicare payment policies
  • Provides payment information for all services performed in your RT/pulmonary function, cardiopulmonary and sleep study departments — this is the perfect companion to our Coding Essentials for RT/Pulmonary Function book

CPT® is a registered trademark of the American Medical Association.

2020 Coding Essentials for RT/Pulmonary Function

Coding Essentials for RT/Pulmonary Function

From ensuring prior authorization for sleep studies to meeting medical necessity requirements for pulmonary/respiratory rehab, this trusted book delivers comprehensive instruction and tips.

RT services, PFT, sleep studies and more — all covered in one convenient book!

In one resource you’ll find complete guidance with coding, charging, billing and documentation for respiratory therapy/pulmonary function services and sleep studies. With the help of our expert authors, you’ll consistently capture the full, appropriate payment while avoiding risky practices, such as insufficient documentation, unbundled coding and modifier misuse.

Features and Benefits

Our RT/PFT experts address common questions, concerns and problem areas:

  • High-risk practices inherent with polysomnography and other sleep studies, such as insufficient prior authorization and incorrect coding for home sleep study tests
  • Billing issues with breathing treatments — a prime RAC target — and billing sequence or date of service
  • Unbundling of codes and groups of CPT/HCPCS codes that are inappropriately reported together
  • Incorrectly billing for routine monitoring, oxygen and services not specifically ordered by a physician
  • Medicare medical necessity coverage policies and frequency limitations
  • Lack of documentation to support medical necessity

Clear, step-by-step guidance through the tasks you perform every day:

  • Coding, documentation and billing for a full range of respiratory therapy services and pulmonary function testing, plus polysomnography and other sleep studies
  • Covers code assignments by both hospital (technical) and physician (professional) entities

A proven approach to effective learning and quick reference for busy professionals:

  • Easy to navigate; each section contains:
    • Descriptions and intended uses of services provided
    • Listings of the corresponding CPT/HCPCS and revenue codes, along with explanations of intended code usage
    • Modifier usage, where appropriate
    • Documentation and medical necessity requirements
    • Billing tips
    • Clinical examples
  • Complete payment information, including:
    • Current hospital OPPS rates
    • Procedures with APCs, status indicators and at-a-glance tables showing CPT/HCPCS codes included in APCs, plus prior year and current payment rates
    • National and local coverage determinations (LCDs/NCDs)
    • Advance beneficiary notices (ABNs)
    • National Correct Coding Initiative (NCCI) edits

CPT® is a registered trademark of the American Medical Association.

Available at the AARC store

LIVE DECEMBER 3 WEBCAST: 2020 Respiratory Therapy Reimbursement & Compliance Update

WEBCAST: 2020 Respiratory Therapy Reimbursement

11:30 a.m. – 1 p.m. CT.

From understanding new payment rates to learning how to code and bill correctly for a full range of RT and pulmonary function services, you’ll take away knowledge designed to help protect your bottom line.

This Live Webcast is approved for 1.5 CRCE.

Webcast Highlights:

  • Guidance through 2020 code revisions for airway resistance and EEGs, plus HCPCS and NCCI updates specific to RT services and in-depth information on the 2020 OPPS final rule and the impacts for RT providers.
  • New discussion and examination of common problem areas and missed revenue opportunities, including what should not be coded and why coding for productivity count may be detrimental to RT departments.
  • Coding and documentation tips, with a special emphasis on the gray areas of “medical indications” versus “medical necessity” in the physician order, plus knowing when medical necessity extends to durable medical equipment.
  • Tips on how to correctly interpret and apply CPT®/HCPCS codes for the billing of a full spectrum of RT/ pulmonary function services, including pulmonary rehab, RT rehab, and polysomnography/sleep studies.
  • Step-by-step instruction through challenging scenarios for coders, such as determining which CPT codes should be used during a problem-oriented office visit.
  • Guidance with ambiguous billing opportunities, such as nitrous oxide administration for a minor procedure in the emergency department and how many times you may report CPT code 94640 for multiple inhalation treatments during a single episode of care.
  • Coding and billing requirements for polysomnography, including device pass-through payment status for 2020.

Webcast will also be available on-demand after the Dec. 3 airdate.

CPT® is a registered trademark of the American Medical Association.

Available at the AARC store