Pulmonology Coding Alert

Question: The pulmonologist treats a patient with shortness of breath and coughing. The pulmonologist performs a level-three emergency department (ED) visit, then orders simple spirometry. Based on test results, the physician diagnoses chronic obstructive pulmonary disease (COPD) with acute bronchitis. I reported 94010 and 99283, and the insurer rejected the spirometry code. What did I do wrong? Connecticut Subscriber Answer: A spirometry is not separately billable by the pulmonologist who sees a patient in the ED. You cannot report 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation) for this encounter. You could report 94010-26, if the pulmonologist interpreted the spirometry for the hospital pulmonary function lab. In the future, see if you can roll the spirometry work into the overall E/M level. There is a chance you could increase the overall service level. Benefit: If the pulmonologist performed [...]