Remote Monitoring of Peak Expiratory Flow

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Woman using peak flow monitor
by Lucy Lamboley

The U.S. healthcare system has made some big advancements in the acceptance and usage of telemedicine and remote patient monitoring devices. While the benefits of these services are proving to be valuable for all patients, they are even more important for patients with chronic conditions, including those with lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), and bronchiectasis. With the looming threat of COVID-19 exposure, it may no longer be realistic or safe to continue permitting vulnerable patients to visit a practice for respiratory services. However, the exciting news is that peak expiratory flow can now be measured and monitored remotely with the help of a connected smart peak flow monitor.  

Value of Remote Patient Monitoring With Peak Flow Monitors 

Patient wellness and illness prevention is a major concern for those with chronic lung issues. A seemingly benign illness can become serious very quickly, leading to office visits, hospitalizations, or even death. According to the Centers for Disease Control and Prevention, patients with a chronic lung disease diagnosis account for a staggering 5.7 million office visits and more than 900,000 emergency room visits per year. Healthy People 2020 also notes that more than 25 million Americans have asthma and nearly 15 million adults have been diagnosed with COPD. Even before the current pandemic health crisis, COPD was listed as the third leading cause of death by disease worldwide in 2015 and had an astonishing hospital readmission rate of 22.6%.  

The reality is that patients with asthma, COPD, and other chronic breathing conditions are at an increased risk of developing deadly complications just by walking into their practitioner’s office. This was the case even before COVID-19. As a result of the health crisis, healthcare providers must be proactive in providing continued care, but in a safer and more socially distant manner. Peak flow monitors can help bridge the care void created by reduced in-person visits, better ensure that patient treatments are working as intended and helping prevent or detect the onset of exacerbations earlier.  

The benefits of remote peak expiratory flow monitoring are numerous, especially for patients and practitioners looking to monitor and manage respiratory conditions such as COPD, asthma, bronchiectasis and others. For patients with asthma, close monitoring of peak flow measurements will help identify asthma flare-ups early, enabling patients to seek appropriate treatment sooner. In addition to peak expiratory flow, the following parameters are often measured with peak flow: FVC, FEV1, FEV1/FVC, FEF2575, FEV6, VEXT, DTPEF, FEF75, FET, FEF25, FEF50, FIVC, FIV1, PIF, FEV3, FEV05, FEV075, and FEV2. 

Practitioners and their patients also gain better insight into treatment plans and are better equipped to identify and react when treatment isn’t delivering the desired results. Remote peak expiratory flow monitoring can even help with identifying asthma triggers, allowing practitioners to quickly determine necessary changes to a medication regimen.  

Reimbursement for Remote Peak Flow Physiological Monitoring 

Remote peak expiratory flow monitoring is not only good for patients, but it’s good for practices as well. The service falls under the broader range of remote patient monitoring services approved by Medicare. As long as practices use an FDA-cleared peak flow meter device and meet Medicare billing guidelines and conditions, remote peak flow monitoring will deliver generous reimbursement. Similar to other RPM services, remote peak flow monitoring generates an average income of about $120 per month, per qualifying Medicare patient.  

CPT Coding for Remote Peak Flow Physiological Monitoring  

Practices that offer remote peak expiratory flow monitoring will likely bill using four CPT codes, which conveniently are the same billing codes as other RPM services. They can be summarized as follows: 

CPT 99453

Initial enrollment and setup ($21 in Medicare reimbursement) 

CPT 99454  

Remote monitoring and management of device readings (averages $64 in Medicare reimbursement) 

CPT 99457 

First 20 minutes of clinical staff time communicating with patient or caregiver (averages $55 in Medicare reimbursement) 

CPT 99458  

Additional 20 minutes of clinical staff time communicating with the patient or a caregiver. This code can be used two times for a total of 20 minutes each. (averages $44 in Medicare reimbursement) 

RPM Billing Guide schedule

To learn more about these codes and how to bill for them, download our RPM billing guide

Since remote peak flow monitoring has the support of Medicare and a growing number of private payers, it is likely a worthwhile service to add to your repertoire.  

What’s New and Exciting In Remote Peak Flow Monitoring 

Healthcare and technology professionals are leveraging this creativity and ingenuity to help meet the evolving demands of patient care. Technology evolutions are helping practitioners better meet patients where they are located, paving the way to deliver timely, high-quality care in the safest manner. Monitoring peak expiratory flow remotely is just one of the exciting advancements that will improve your patients’ quality of life while enhancing the care you deliver and your practice’s bottom line.  

New technologies combined with existing smart devices make monitoring peak expiratory flow remotely easier than ever. Digital spirometers that capture peak expiratory flow, such as those developed by Medical International Research, are now set up to use Bluetooth or WiFi connections, enabling easy linking to tablets, smartphones, and other platforms and devices. Patient data is captured and transmitted securely through connected software portals into a pulmonology remote patient monitoring solution, providing practitioners with accurate and current information about a patient’s health status. Since peak flow monitoring devices connect directly to a patient’s existing smartphone or tablet, there’s little room for user error. In addition, patients have access to easy-to-use and understand applications that help encourage active participation in their own care.   

Integrating Remote Peak Flow Physiological Monitoring to Your Practice 

At Prevounce, we have partnered with an industry-leading technology partner to bring remote peak flow monitoring devices to your practice and your patients. With the goal of keeping patients healthy, the benefits of these devices are numerous, especially considering COVID-19 fears, which are likely to linger for some time. Patients with chronic lung diseases are at an increased risk of illnesses just by leaving their homes to visit their practitioner, but with the help of remote peak flow monitoring, practitioners can continue to provide patients with quality respiratory care from a distance that’s safer for everyone.

For more information on remote patient monitoring, see our comprehensive guide.

RPM Billing Guide

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