A pulmonary group may run a clinic, a pulmonary function lab, a bronchoscopy schedule, and ICU coverage in the same week. Each produces claims under different rules, and critical care is paid on total time that has to be documented. The ICU side is often where the most money slips.
Book a demoOutpatient lung care, diagnostic testing, and hospital critical care follow different rules. Treat them as separate lanes.
Medicare pays 99291 for the first block of critical care, and 99292 applies only once cumulative time reaches 104 minutes. When an intensivist and an NP or PA share the work, the claim carries modifier FS and goes under whoever performed the substantive portion.
PFTs run in your own lab can bill as a global service, while a read of a hospital study bills the professional component only. Bronchoscopy at a hospital or surgery center brings a facility claim alongside yours.
The DME supplier bills Medicare for home oxygen, but the claim rests on your records: a qualifying blood gas or oximetry test that the treating practitioner ordered and evaluated. CMS reports insufficient documentation as the leading cause of improper oxygen payments.
Pulmonary claims draw on hospital records, lab reports, and supplier requests. Each needs someone accountable.
Your physicians and advanced practice clinicians document critical care time, procedure findings, and test interpretations, and approve codes before they go out.
With a confirmed fit, Taiga would draft codes from those records, check eligibility, scrub claims for time thresholds and modifiers, and follow every denial through appeal.
Oxygen and CPAP suppliers will ask for qualifying tests and notes. Decide who answers those requests, since the supplier's payment depends on them.
A de-identified ICU note, a PFT report, and a few recent denials are enough to start. Please leave patient names out of the demo request.
List each ICU and hospital service, how notes reach billing, and whether NPs or PAs share critical care visits.
Say whether your PFT lab and bronchoscopy suite are practice-owned or hospital-based.
Point to the denials that repeat, such as critical care time, same-day hospital visits, or test components.
Worth a conversation if your group bills its own professional claims across clinic and hospital work and wants critical care time captured the same way every shift. Taiga runs next to the EHR you chart in today.
This page covers the group's professional claims. Hospital facility charges and supplier claims for oxygen or other equipment are billed by those organizations, and sleep testing has its own page.
Neither is on Taiga's published specialty list. Share how your clinic, lab, and ICU work splits and you will get a direct answer on fit.
Medicare recognizes 99292 only once total critical care time reaches 104 minutes. Below that, the day is billed with 99291 alone.
The practitioner who performed the substantive portion bills it, with modifier FS on the critical care codes. The record should show each clinician's time.
Medicare allows it in certain circumstances when documentation supports both. The record should show the visit and the critical care as distinct services.
Walk Taiga through one de-identified week across the clinic, the lab, and the ICU. You will hear which parts Taiga can take on and how the switch would go.
System guides show possible billing handoffs, not proven specialty compatibility.