Shirley Sykora
Westmont, Ill.
Answer: HCFA includes procedures for codes 94620 (pulmonary stress testing; simple [e.g., prolonged exercise test for bronchospasm with pre- and post-spirometry])and 94621 (pulmonary stress testing; simple [e.g., prolonged exercise test for bronchospasm with pre- and post-spirometry]; complex [including measurements of CO2 production, O2 uptake, and electrocardiographic recordings]) in its list of non-clinical diagnostic tests. This list also includes audiology and echo tests, vascular studies, pulmonary and allergy testing, neurology tests, electroencephalogram (EEG), electrocardiogram (ECG/EKG), respiratory function tests and cardiac evaluations.
For more information, see the HCFA Carriers Manual, HCFA Publication 14, related fraud rules in HCFA Publication 14-3 or visit the HCFA Web site at www.hcfa.gov.
Editors note: Cynthia Thompson, CPC, senior consultant at Gates, Moore & Co, a physician-practice management-consulting firm in Atlanta, answered this question.