Pulmonology Coding Alert

Question: If we perform pulmonary function tests (PFTs) and spirometry at the hospital, which code should we report? And should we append a modifier?

Arizona Subscriber

Answer: There is no CPT^® code for pulmonary function tests. You should code for the specific tests the pulmonologist administered to the patient. When the physician interprets the tests from a pulmonary function lab not owned by the practice, you should only report the professional component of this service. Report the appropriate code such as 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation) with modifier 26 (Professional component) appended.

If the physician measures simple spirometry before and after bronchodilation, you should report 94060 (Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration) with modifier 26 for the professional component, which includes all of the work of 94010 but gives a better analysis of the problem and the effects of treatment.