Pulmonology Coding Alert

Question: Can I bill for a spirometry when an office visit is also billed?

Oregon Subscriber

Answer: Code 94010 (spirometry, including graphic record, total and timed vital capacity, and expiratory flow rate measurement[s], with or without maximal voluntary ventilation) includes laboratory procedure(s) and interpretation of test results.

If a separate identifiable E/M service is performed, the appropriate E/M code should be reported in addition to 94010. The Correct Coding Initiative (CCI -version 6.3) requires that you attach modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the E/M code. Although these edits will not take effect until July 2001, it is safer to place modifier -25 on the claim in preparation for the implementation.