Pulmonology Coding Alert

Question: We perform pulmonary function tests (PFTs) on an outpatient basis at the hospital, and we bill for PFTs and spirometry procedures with modifier -26. What is the difference between these two codes?

Connecticut Subscriber  Answer: There is no CPT code for pulmonary function tests. You should code for the specific tests the pulmonologist administered to the patient. When the physician interprets the tests from a pulmonary function lab not owned by the practice, you should report 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation) with modifier -26 (Professional component) for simple spirometry (forced vital capacity with flows).

If the physician measures simple spirometry before and after bronchodilation, you should report 94060 (Bronchospasm evaluation: spirometry as in 94010, before and after bronchodilator [aerosol or parenteral]) with modifier -26 for the professional component.