Pulmonology Coding Alert
Remember Whose Equipment You're Using On Spirometry Claims
Question: Our pulmonologist ordered a spirometry on one of our patients at the hospital. I reported 94010 and received a denial. What did I do wrong? For this encounter, the hospital will bill for the technical component of 94010.
Nebraska Subscriber
Answer: You probably got the denial because the procedure was performed in a hospital.
When your pulmonologist orders spirometry in a facility setting and interprets the test, you're only allowed to report the professional component of the code, even if you own the equipment.
Do this: The next time your physician interprets a spirometry in a facility setting (for example, place of service 21 or 22):
• report 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation) for the procedure
• attach modifier 26 (Professional component) to 94010 to show that you are only billing for your pulmonologist's service, not the technical portion.
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