Respiratory therapists play a crucial role in many facets of healthcare — and their importance has only been magnified during the COVID-19 pandemic. Given the scope of medical knowledge they must possess, respiratory therapists have precious little time to master disciplines related to, but not part of, their core competencies. This includes coding, charging, billing, and documentation.
Years ago, MedLearn Publishing recognized the significant financial impact of RT departments on their organizations. This is coupled with the fact that RT directors and therapists, as well as coders and billers, need an easy-to-understand and easy-to-use resource to guide them in their decisions. These factors inspired the development of our Coding Essentials for Respiratory Therapy/Pulmonary Function book and other RT resources.
For this “Industry Expert Review,” we asked our lead RT expert, Robin Miller Zweifel, BS, MT (ASCP), for her take on the popularity of these products over the years.
Challenges for RT professionals: One of the biggest areas of confusion is which services are billable and which are not. For example, therapists spend a lot of time on inhalation treatment. However, because of changes to CPT® coding guidelines, this may not be a billable service. It really comes down to documentation and the physician order, plus NCCI policy and payer guidelines, as to whether and how many breathing treatments may be billed. This is a conversation I have almost every time I talk to respiratory therapists.
Favorite attributes: I think Coding Essentials for Respiratory Therapy/Pulmonary Function and other MedLearn Publishing RT resources do a great job of covering all types of services that a respiratory therapist may provide, including RT treatments, pulmonary rehab, tobacco counseling, remote monitoring, and sleep studies. Also, we use plain English to explain concepts that may not be familiar to RT professionals, especially what’s necessary in order to charge and bill for CPT® codes.
Tools for empowerment: Respiratory therapy staffing has been one of the hardest hit areas in healthcare; we even see RT directors being pulled to the floor to help with patient care. On top of that, patient acuity has increased dramatically due to the pandemic — but a lot of services provided to COVID-19 patients are not chargeable. Our RT resources provide trusted, easy-to-understand guidance that can be used by everyone who touches the RT revenue stream, ensuring compliant charging, coding, and billing.
Value for training: We may have done our very best work in creating an RT book with lay language that can be understood by coders and billers, as well as by someone who’s brand new in RT, or even a manager. It’s also a great resource for sharing between RT professionals and coding or billing staff, enabling them to have productive conversations and make sure they’re on the same page.
Uniqueness vs. other resources: Coding Essentials is still the only comprehensive RT coding book on the market. In addition, we went to great lengths to make sure we got input from respiratory therapists and then incorporated their ideas into the book. It’s really built with the respiratory therapist in mind, and we’ve seen the payoff through wide acceptance by RT departments.
Staying up to date: While CPT® codes have been largely stagnant for the past several years, we see significant ongoing changes in other areas, such as coding guidelines, coverage determinations, NCCI policy and payer audits. By having the latest information at your fingertips, you reduce your risks for costly mistakes. For example, consider pulmonary function testing — a mainstay of outpatient RT. If you perform eight to 10 PFTs per day and you’re over-charging or under-charging, think of the cumulative impact on your reimbursement. A small annual investment in educational resources could potentially be recouped many times over.
Click here for more information about MedLearn Publishing respiratory therapy resources.
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In the FY 2027 Inpatient Prospective Payment System (IPPS) Proposed Rule, the Centers for Medicare and Medicaid Services (CMS) has introduced a notable and potentially
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