Pulmonology Coding Alert

Question: Our pulmonologist often performs bronchospasm evaluations at our office. I want to know whether or not spirometry conducted during bronchospasm evaluations can be reported separately?

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Answer: Spirometry is a pulmonary function test that is often conducted for the diagnosis of a wide variety of respiratory problems such as asthma and chronic obstructive pulmonary disease (COPD). Spirometry helps determine lung volumes and also helps in understanding about the lung function. If your pulmonologist performs spirometry alone and does not perform any other pulmonary function test, then you can report the procedure with 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation).

When your pulmonologist performs bronchospasm evaluations, he will use a bronchodilator as well as perform spirometry, to assess the airways' response. Your pulmonologist might perform multiple spirometries to assess the response of the airways to the bronchodilator that he is using for dilation.

If spirometry is being done to assess the responsiveness of the airways to the effects of the bronchodilator as is done in a bronchospasm evaluation, then you have to report the procedure with 94060 (Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration). Here you do not code separately for the spirometry as Correct Coding Initiative (CCI) edits bundle the spirometry codes into the codes for bronchospasm evaluation without the ability to unbundle it, even when appropriate to do so.

Note that the bronchodilator supply should be reported with 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]) or any other appropriate HCPCS supply code.