Pulmonology Coding Alert
Unbundling
Question: I am trying to code pulmonary function studies. I am being given four codes: 94010, 94060, 94200 and 94375. The only one being paid by Medicare is 94060. In what situations would the other three codes be paid?
Shelly Lynn
Danville, Ky.
Answer: The CPT codes you have listed (94010, 94200 and 94375) are considered bundled in the comprehensive CPT code 94060 and will not be paid separately when done during the same session as 94060.
Using the national Correct Coding Initiative manual to check for bundling edits will help you avoid unexpected denials. Copies can be purchased from National Technical Information Service (NTIS) and are updated quarterly. Unfortunately, they do not have all of the bundling edits that exist. You need to contact your local Medicare carrier and ask about the latest bundling issues.
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