Radiology Coding Alert

Question: What code should I report for a fluoroscopic "sniff" test to evaluate diaphragmatic motion?

New Jersey Subscriber

Answer: You should 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.

Watch out: Your payer may not cover a sniff test with no films, but you must code the procedure as performed.

If the procedure produces a two-view chest x-ray with the fluoroscopic test, report 71023 (Radiologic examination, chest, two views, frontal and lateral; with fluoroscopy).

For four or more views, report 71034 (Radiologic examination, chest, complete, minimum of four views; with fluoroscopy).

Your most likely ICD-9 option is 519.4 (Disorders of diaphragm), but you should only report the diagnosis documented by the physician.

Note: The name "sniff" test stems from the physician using fluoroscopy while the patient sniffs to allow the physician to test for diaphragm paralysis.