Pulmonology Coding Alert

Question: What codes do I use for a pulmonology function test?

Georgia Subscriber

Answer: The codes for pulmonary function tests vary, depending on the extent performed. One of the most common procedures is 94010 (spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation). This is executed in a pulmonary laboratory. The physician interprets the results of the spirometry, and a graphic record is obtained.

The other common procedure is 94060 (bronchospasm evaluation: spirometry as in 94010, before and after bronchodilator [aerosol or parenteral]). This is similar to 94010 with the addition that the spirometry be performed before and after the use of a bronchodilator or exercise.

Code 94200 (maximum breathing capacity, maximal voluntary ventilation) is used when the patient inhales to the maximum vital capacity then exhales into a spirometer. The physician measures the maximal expiratory flow at 50 and 75 percent of expired vital capacity.

If a separate E/M is performed in addition to the above, it may be reported with modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service). Do not count the interpretation in the medical decision-making component of the E/M level as it is already inclusive of the performance.