Pulmonology Coding Alert

Question: CPT^® code 94060 includes bronchodilator administration, but can we bill the bronchodilator drug code separately?

Louisiana Subscriber

Answer: Yes, you can bill the bronchodilator drug code separately with 94060 (Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration). The code covers the bronchodilator administration but not the drug used.

Code 94060 features a parenthetical note instructing you to report the bronchodilator supply separately with 99070 (Supplies and materials (except spectacles), provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided)) or an appropriate supply code.

Important: Most payers do not reimburse for 99070, so you should review your individual payer’s preferences regarding how they’d like you to report the bronchodilator supply.

Scenario: Patient presents for spirometry before and after bronchodilator administration. The pulmonologist performs spirometry, administers 1 mg albuterol inhalation solution, and then repeats the spirometry procedure.

In this scenario, you’ll assign 94060 for the spirometry before and after bronchodilator administration. Next, you’ll assign J7613 (Albuterol, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose, 1 mg) to report the albuterol supply.