Pulmonology Coding Alert

Question: I'm confused about whether pre- and post-spirometry is required when I report 94620 for a six-minute walk. Would you explain how to accurately report this procedure, especially if the pulmonologist does not conduct pre- and post-spirometry?


Pennsylvania Subscriber

Answer: Spirometry (pre- or post-) is not part of the testing when your pulmonologist orders a six-minute walk test. The six-minute walk test measures the distance walked over six minutes; the pulmonary function technologist encourages the patient to walk as fast as possible throughout the test, and the technologist measures the patient's oxygen saturation, heart rate and dyspnea.
 
This is a simple pulmonary stress test. Since the pulmonologist requests the test, you should report 94620 (Pulmonary stress testing; simple [e.g., prolonged exercise test for bronchospasm with pre- and post-spirometry]) for the six-minute walk test.

Note: If the pulmonologist also orders spirometry or spirometry before and after bronchodilator, report it separately from the pulmonary stress test. Add modifier 59 (Distinct procedural service) to 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation) or 94060 (Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration) to indicate that the test is a separate test from 94620.

If the documentation is appropriate, modifier 59 will unbundle the National Correct Coding Initiative edit that includes 94620 with 94010 or 94060.