Reader Questions:
Make Sniff Test Coding a Snap
Published on Mon Feb 27, 2006
Question: Our doctor performs a fluoroscopic "sniff" test to evaluate diaphragmatic motion. We're having trouble getting insurers to cover CPT 76000 for this procedure. Is there a more accurate code for a sniff test?
Georgia Subscriber Answer: Careful ...quot; you must report 76000 (Fluoroscopy [separate procedure], up to one hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) if the radiologist produces no films, even if your insurance company won't pay.
If the procedure produces a two-view chest radiographic exam along with the fluoroscopic test, report 71023 (Radiologic examination, chest, two views, frontal and lateral; with fluoroscopy). If you have four views, report 71034 (Radiologic examination, chest, complete, minimum of four views; with fluoroscopy). You're more likely to see a scenario with films than without.
The insurance company's denial may stem from the diagnosis code you pair it with. Your most likely option is ICD-9 code 519.4 (Disorders of diaphragm), so check with your payer to see if it covers that code combination. Remember: You can only report the diagnosis documented by the physician.
The procedure: To test for diaphragm paralysis, the physician uses fluoroscopy while the patient sniffs, resulting in the name "sniff test."