Pulmonology Coding Alert

Question: When doing a flow volume loop for spirometry on a regular basis, should I bill 94375 or 94060?

California Subscriber

Answer: Spirometry is used to assess ventilatory function. It measures how well the lungs take in air, the volume of air the lungs hold, and how well the lungs exhale air. During a basic spirometric study (94010), a spirometer is used to measure tidal volume, inspiratory reserve volume, expiratory reserve volume, residual volume, inspiratory capacity, and vital capacity. 94060 (Bronchospasm evaluation: spirometry as in 94010, before and after bronchodilator [aerosol or parenteral]) is used to report spirometric measurements before and after bronchodilation.

If you perform a flow volume loop by itself, you should use 94375 (Respiratory flow volume loop).However, this PFT is an integral part of spirometry, so 94375 is bundled into 94010. If you perform a spirometric measurement, do not code separately for flow volume measurement. The same applies to 94060, which includes the following PFT codes: 94010, 94200, 94375, 94640, 94664, and 94770. Therefore, use 94060 when you perform the full bronchospasm evaluation. If the physician only performs a flow volume loop, without any spirometry or bronchodilation evaluation, report 94375.