Pulmonology Coding Alert

Question: I have all the CPT codes for the various pulmonary function test (PFT) interpretations. However, on a complete PFT study, is there one code to bill with modifier -26 (professional component) for everything or can our physician bill for each individual procedure? For example: If a patient has complete PFTs (diffusion capacity of the lung using carbon monoxide [DLCO], spirometry w/bronchodilatorplethysmographic method) is there one code for the complete reading or do we bill separately for each?

Jessica S. Greer
St. Lukes Episcopal Hospital, Houston

Answer: Code 94060 (bronchospasm evaluation: spirometry as in 94010, before and after bronchodilator [aerosol or parenteral]) includes the following pulmonary CPT codes: 94010, 94200, 94375, 94640, 94650, 94664 and 94770.

All other procedures can be billed separately.
You append modifier -26 to the CPT code if the procedure was done in a hospital setting and your physician provided a written interpretation and report.