Pulmonology Coding Alert

Answer: Code 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation) is reserved to report spirometry procedures with or without maximal voluntary ventilation (MVV). The MVV portion is optional, so you’ll still only report 94010 regardless of whether the provider chooses to perform the added work.

To correctly report 94010, all components of the procedure as called out in the descriptor must be performed. The documentation should include graphic record, total and timed vital capacity, and expiratory flow rate measurements. If any of those components are missing from the documentation, you cannot assign 94010 and you should query your physician about the missing documentation.

According to the Centers for Medicare & Medicaid Services (CMS) Pulmonary Function Testing (PFT) Billing and Coding article, documentation components should include, but are not limited to:

• At least three spirometry study attempts;
• Documentation supporting the condition and treatment;
• ICD-10-CM codes to show medical necessity and reflect the patient’s condition; and
• Interpretation with a written report.

(www.cms.gov/medicare-coverage-database/view/article. aspx?articleId=57216)