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Pulmonology Coding Alert

Reader Question:

Don't Use Modifier 51 as a Norm to Separate PFT Components

Published on Tue Sep 25, 2012

Question: When billing multiple components of a pulmonary function test, do I have to use a modifier 51 on the lines other than the first? Also, let me know when I need to use modifier 26 for a pulmonary function test?Cincinnati SubscriberAnswer: As per Correct Coding Initiative (CCI) edits, when your pulmonologist performs a bronchospasm evaluation (94060, Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration) as part of the pulmonary function tests, these following services are bundled into it:94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation)94375 (Respiratory flow volume loop)94200 (Maximum breathing capacity, maximal voluntary ventilation)94640 (Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes [e.g., with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device])94664 (Demonstration and/or evaluation of patient utilization of an [...]
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