Pulmonology Coding Alert

Question: What is the difference between pre- and postspirometry (94060) and pulmonary stress testing (94620)? For example, the pulmonologist sees a patient with suspected interstitial lung disease. I checked his resting and exercise pulse oximetry and vital signs. Can I use 94620 with this?

Pennsylvania Subscriber

Answer: You should use 94060 (Bronchospasm evaluation: spirometry as in 94010, before and after bronchodilator [aerosol or parenteral]) for spirometric testing before and after bronchodilation to measure the patient's response to the bronchospasm treatment. But 94620 (Pulmonary stress testing; simple [e.g., prolonged exercise test for bronchospasm with pre- and postspirometry]) can represent the physician administering spirometry and other such testing before and after exercise.

Watch out: Many coders get stress testing confused with 94761 (Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations [e.g., during exercise]). This code represents pulse oximetry, which measures oxygen desaturation or identifies oxygen flow in the prevention of desaturation. You can't report this code on the same day as an E/M service.

-- Answers for You Be the Coder and Reader Questions were answered by Carol Pohlig, BSN, RN, CPC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia; and Alan Plummer, MD, chief of pulmonary disease, allergy and critical care at Emory University Hospital in Atlanta.