Pulmonology Coding Alert

Question: Our pulmonologist performed a cold air challenge, which is a type of pulmonary stress test. What is the correct code for the procedure?

Maine Subscriber

Answer: The correct code for the procedure is 94070 (prolonged postexposure evaluation of bronchospasm with multiple spirometric determinations after antigen, cold air, methacholine or other chemical agent, with subsequent spirometrics). A patient frequently will present to the pulmonologist with shortness of breath (786.05) and a cough (786.2). The physician may choose to perform spirometry (94010) to determine the patients baseline function. The baseline study may be normal.

To determine what the patients airway is reacting to when he or she becomes short of breath with a cough, the pulmonologist will administer a challenge to the patient using an external agent in this case, cold air. After administering the agent, the physician performs subsequent spirometrics to identify the effects of the challenge. If necessary (if the patient develops significant bronchospasms), the physician may need to administer a bronchodilator to the patient to relieve his or her symptoms.

This reader question was answered by Susan Callaway, CPC, CCS-P, an independent coding consultant and educator in North Augusta, S.C., and Carol Pohlig, CPC, RN, a reimbursement analyst for the office of clinical documentation, Department of Medicine at the University of Pennsylvania in Philadelphia.