Pneumonia is a common infectious disease that can affect one or both lungs. The condition can be community-acquired (CAP), health care-associated (HCAP), hospital-acquired (HAP), or ventilator-associated (VAP). Caused by bacteria, viruses, or fungi, this lung infection can inflame the air sacs (alveoli) in one or both lungs. Diagnosis of pneumonia involves a comprehensive evaluation of the patient’s medical history and a physical examination to detect abnormal sounds such as bubbling or crackling in the lungs, indicating the presence of the condition. Additional diagnostic tests such as chest X-ray, pulse oximetry, sputum analysis, and blood tests may be necessary for a more precise diagnosis. Healthcare providers who treat this contagious respiratory illness can rely on medical billing and coding companies to ensure accurate claim submissions.
Accurate medical coding for pneumonia depends on detailed clinical documentation in the patient’s medical record that specifies the type of pneumonia or its underlying cause. Proper identification of the severity of the illness is crucial for correct code assignment, which, in turn, is vital for ensuring appropriate reimbursement.
When reporting pneumonia in medical claims, the specialist should ensure the documentation specifies the type and etiology to assign the most accurate code. Pulmonary medical coding services provided by AAPC-certified coders can help infectious disease specialists report the condition correctly and optimize reimbursement.
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Holding a CPC certification from the American Academy of Professional Coders (AAPC), Natalie is a seasoned professional actively managing medical billing, medical coding, verification, and authorization services at OSI.