Unlisted pulmonary service or procedure

Description

This code is utilized to report pulmonary services or procedures that do not have a designated CPT code. It allows healthcare providers to document and bill for unique pulmonary interventions that fall outside standard coding options.

Medicare Hospital Outpatient Reimbursement (OPPS)

OPPS Payment Rate

$156.46

Calculation:

x=$156.46

Patient Copayment / Coinsurance

$31.30

Calculation breakdown:

Minimum (20% of rate)$31.30

Top Modifiers

Graph View

List View

HCPCS/CPT 26Professional component of diagnostic services(54.96%)

HCPCS/CPT GCServices performed by a resident under the supervision of a teaching physician(6.87%)

HCPCS/CPT 59Distinct procedural service for non-E/M services(4.2%)

HCPCS/CPT 51Multiple procedures performed by the same provider(1.91%)

HCPCS/CPT CRCatastrophe or disaster-related service modifier(1.15%)

HCPCS/CPT GWService unrelated to hospice patient's terminal condition(1.15%)

HCPCS/CPT GZItem or service expected to be denied as not reasonable and necessary(1.15%)

HCPCS/CPT XUUnusual non-overlapping service(0.76%)

HCPCS/CPT AQService rendered in a health professional shortage area(0.76%)

HCPCS/CPT LTModifier for procedures performed on the left side of the body(0.76%)

Code Crosswalks

No crosswalks found.

Alternate Codes

No alternates found.

Billed With Codes

No codes found here.

Sources

We make no claims to ownership of the coding systems referenced on this platform. Codes and descriptions are produced from claims and chargemaster data available through the CMS-9915-F Transparency in Coverage Final Rule and via state or federal datasets. This service is provided solely as a reference to encourage use of these codes in our chargemaster review and automated billing tools, so that healthcare professionals can understand and correctly report these codes in their claims.

Federal and State Datasets

List of CPT/HCPCS Codes, Centers for Medicare & Medicaid Services (CMS)
I/OCE Quarterly Release Files, Centers for Medicare & Medicaid Services (CMS)
Physician Fee Schedule Relative Value Files, Centers for Medicare & Medicaid Services (CMS)
OPPS Addendum B, Centers for Medicare & Medicaid Services (CMS)
ASC Payment Addenda, Centers for Medicare & Medicaid Services (CMS)