Pulmonology Coding Alert

Question: The pulmonologist in our practice administered at-home spirometry for a patient following a lung transplant. The patient was instructed to perform the test each day at 10:00 am and record their results for one month. At the end of the month, the patient returned and the pulmonologist discussed the results.

What codes should I assign to report this procedure?

Connecticut Subscriber

Answer: You have three CPT^® codes to choose from depending on which component of the procedure you’re reporting. Codes related to patient-initiated spirometric recording include:

• 94014 (Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and review and interpretation by a physician or other qualified health care professional)
• 94015 (… recording (includes hook-up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration))
• 94016 (… review and interpretation only by a physician or other qualified health care profes­sional)

You may report patient-initiated spirometric recording codes once every 30 days, even though the provider may receive data at several different times during the same timeframe.

Code 94014 represents the procedure where the patient performs spirometry at home at a certain time each day. The patient will record the findings over 30 days. This code includes both the technical and professional components.

If the provider performs only the technical component, which includes setting up the equipment, educating the patient on the equipment’s use, transmitting data, or recalibrating the machine, then you’ll assign 94015. You’ll assign 94016 to report the physician’s or another qualified healthcare professional’s interpretation of the data (only the professional component).

Modifiers need not apply: CPT^® codes 94015 and 94016 represent the technical and professional components of the service, respectively. This means you shouldn’t append modifier 26 (Professional component) or TC (Technical component) with the codes.