Pulmonology Coding Alert

Question: I have a report that indicates a pulmonologist performed a car seat test on a 1-month-old patient to evaluate the infant’s airways. The infant was born prematurely at 36 weeks. The pulmonologist documented the car seat test lasted for 90 minutes. I’m new to coding and haven’t heard of a car seat test.

How do I report this procedure?

Michigan Subscriber

Answer: You’ll assign 94780 (Car seat/bed testing for airway integrity, for infants through 12 months of age, with continual clinical staff observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; 60 minutes) and +94781 (… each additional full 30 minutes (List separately in addition to code for primary procedure)) to report the procedure.

Code 94780 covers the first 60 minutes of the car seat test, and you report +94781 for the additional 30 minutes. According to its descriptor, you may report +94781 only if the test lasts for a full 30 minutes in addition to the first hour, and you can report the code only in conjunction with 94780. Also, AMA CPT^® guidelines indicate that the physician should not report 94780 for testing that lasts less than 60 minutes.

During a car seat test, the provider continuously monitors the baby in a car seat while the patient’s respiratory rate, heart rate, and pulse oximetry are recorded throughout the length of the test. After the test, the provider will interpret the results and write a report.

Typically, like in the case of the patient in your question, providers perform car seat tests before the patient is discharged home from the neonatal intensive care unit (NICU) or hospital. The test allows providers to evaluate babies born prematurely or who are at risk of developing heart disease or who have congenital malformations.