Pulmonology Coding Alert

Question: We measured lung volume and now have been rejected for using code 94278. Is 94726 the correct choice?

Mississippi Subscriber

Answer: Code 94728 (Airway resistance by impulse oscillometry) measures the level of obstruction to airflow noninvasively by a device transmitting pressure oscillations to the patient’s mouth. It typically is used to diagnose asthma-like pathologies in children. This would not define lung volumes specifically. Therefore, as you suggest, 94726 (Plethysmography for determination of lung volumes and, when performed, airway resistance) would be a better choice, as it denotes measurement of the lung volumes using the Plethysmography method. It also measures airway resistance, or the obstruction to airflow in the lungs.

If your provider used the helium dilution or nitrogen washout method to determine the lung volumes, you can report 94727 (Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes) instead.