Pulmonology Coding Alert

Question: What is correct coding for a peak flow rate done in-office with a peak flow device prior to an allergy shot? Would it be 94200 (Maximum breathing capacity, maximal voluntary ventilation) or 94150 or another? New York Subscriber Answer: You should report 94150 (Vital capacity, total [separate procedure]) for peak flow measurements. There is not a distinct code for peak flow rate. This measurement is incorporated into the code for spirometry. During this procedure, a spirometer is used to measure peak expiratory flow rate, which is a measurement of lung mechanics. Peak flow rate is a simple test, and it has a "B" status on Medicare's Physician Fee Schedule. Therefore, this measurement is bundled into the E/M services provided. You cannot bill separately for peak flow and be reimbursed unless all of the other measurements are performed and you bill for spirometry. Advice for You Be the Coder and Reader Questions was provided by Carol Pohlig, BSN, RN, CPC, at the University of Pennsylvania department of medicine in Philadelphia; Anthony M. Marinelli, MD, FCCP, chairman of the American Thoracic Societys Clinical Practice Committee; and Karen Jernigan, CPC, CMIS, office manager at the Asthma, Allergy, and Immunology Clinic LLC, James Island, S.C.