Pulmonology Coding Alert

Question: Im wondering if other offices report pulmonary function tests (PFTs) based on why the patient presents for the tests, rather than waiting for the final report to bill the global service. Our previous coder never reported chronic obstructive pulmonary disease (COPD) as a diagnosis even though this is the most likely reason why the patient was taking the breathing test in the first place. Id like to expedite the billing based on the reason why we sent the patient for the PFT rather than waiting for the dictation. Is this is an acceptable practice?

Florida Subscriber

Answer: Many pulmonary function labs bill for studies on the day they are performed and it is common not to confirm a precise pulmonary diagnosis before submitting the bills. Often, coders report ICD-9 codes for symptoms or signs, such as shortness of breath (786.05), wheezing (786.07), cough (786.2), and abnormal chest sounds (786.7), which is certainly allowable.

Be careful, however, that the code you use is pulmonary-oriented and not a code such as benign prostatic hyperplasia (600.0) or a similarly unrelated code which the referring physician may have listed. In this case, you should call the referring physician to obtain a more appropriate code representing the actual indication for pulmonary function testing, such as shortness of breath.