Otolaryngology Coding Alert

Question: I never know when to charge for peak flow separately or when the visit includes the service. What should I code and when?

California Subscriber

Answer: Commonly used with an asthma diagnosis, the peak-flow monitor allows the physician to better understand the patient's asthma state (mild, acute, etc.). Often, allergists refer to this when a patient comes in with asthma and an upper-respiratory infection. They will take a reading with the patient in the office to judge the severity of the condition with the upper-respiratory complication/infection.

From a CPTperspective, when performed, peak-flow rate is an inherent part of the E/M examination, and you should not separately report the test. Don't report 94150 (Vital capacity, total [separate procedure]) for peak flow. Code 94150 describes computerized spirometry, not peak-flow measurement. When your allergist uses the handheld peak-flow meter, count the measurement as part of "the amount and/or complexity of data to be reviewed" medical decision-making element.