Otolaryngology Coding Alert

Question: Can I bill Medicare for code 93720 in addition to the other PFT codes?

Oregon Subscriber

Answer: CPT 93720 (Plethysmography, total body; with interpretation and report) measures thoracic gas volume, compliance of the lung, airway resistance and airway conductance.

Carriers will consider any pulmonary function tests (PFTs) that measure any of these factors (such as, 94260, Thoracic gas volume; 94360, Determination of resistance to airflow, oscillatory or plethysmographic methods; or 94750, Pulmonary compliance study) as components of plethysmography, even if the physician performs the test using different methods. 

You should not include other medically necessary PFTs that provide different lung measurements performed on the same day as plethysmography, a component of 93720. Therefore, you should report the other medically necessary PFTs as long as your documentation can support that it was completed as a separate and necessary procedure.

- Information for You Be the Coder and Reader Questions was provided by a number of coding experts, including Victoria S. Jackson, CEO of Southern Orange County Pediatric Association with five pediatric offices and 11 pediatricians in California; Richard Tuck, MD, FAAP, a member of the American Academy of Pediatrics national committee on coding and nomenclature; Mary Falbo, MBA, CPC, president of Millennium Healthcare Consulting Inc., a healthcare consulting firm based in Landsdale, Pa.; Barbara J. Cobuzzi, CPC, CPC-H, CHBME, president of Cash Flow Solutions, a physician reimbursement company in Brick, N.J.