The Science Journal of the American Association for Respiratory Care

2006 OPEN FORUM Abstracts

LVRS PULMONARY REHABILITATION PROGRAM DESIGN EXCLUSIVELY USING THE LVRS G-CODES FOR BILLING

-  Gerilynn L. Connors, RRT, FAACVPR, Sidnie Hess, RRT, AE-C, Judith Shumway, RRT, Susan Farrell, RRT, NPS, AE-C, Heather Montilla, RRT, Junk Leah RRT, Jill Baker RRT, Tom Malinowski, RRT, FAARC, Tom Arrowsmith, RRT, James Lamberti, MD. Inova Fairfax Hospital, Falls Church, VA.

Background: Pulmonary Rehabilitation (PR) pre- and post LVRS surgery has specific reimbursement G-codes developed by Medicare (CMS) for the surgical site to use.  In working with this patient population we have found a need to design a specific pre- and post surgical pulmonary rehabilitation program beyond the typical comprehensive program to address the needs of this unique surgical patient. A typical comprehensive PR program would not cover issues relating to: post operative management from mechanical ventilation to pain, scar management, coping with post-operative changes as related to medications, Heimlich valve placement, bronchial hygiene of no forced maneuver for a designated period of time, BMI requirements pre surgical and post operative PR home recommendations.

Methods: The components of pulmonary rehabilitation from assessment, education, therapeutic exercise, psychosocial intervention and long term adherence was redesigned to fit the G-codes G0304 preoperative PR LVRS 1 through 9 days and G0305 Post discharge PR LVRS minimum of 6 days. 

Results: The program redesign has allowed us to meet the PR LVRS exercise and education needs of the patient.  The surgical patient is better prepared for the surgery with PR LVRS.

Conclusions:  The CMS LVRS G-codes can be effectively used when the pulmonary rehabilitation program is redesigned for this specific surgical patient. 


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