Pulmonology Coding Alert

Question: What code applies for MIP (maximal inspiratory pressure) and MEP (maximal expiratory pressure) when a pulmonologist performs the tests on a patient to measure his respiratory muscle strength?

California Subscriber

Answer: Usually, you would bill 94799 (Unlisted pulmonary service or procedure). Pulmonologists do MIP and MEP tests to measure a patient's respiratory muscle strength. However, CPT contains no specific code for the measurement of MIPs and MEPs.

Catch: Check with your payer's policy for MIP/MEP billing to avoid unnecessary reimbursement hassles.When submitting a claim with an "unlisted" CPT code, be sure to include a description of the "unlisted" service on the claim form, as well as a reasonable fee for the service. Unlisted codes may represent many service types, and do not have a standard code description or fee associated with them. Be prepared to receive a request for documentation after initial claim submission. The payer will want to see documentation of the service.