Internal Medicine Coding Alert

Published on Fri Mar 03, 2006 PDF

Question: My doctor has always performed six-minute walk tests in the hospital and reported 94620-26 (Professional component). Now he's wondering if he can do them in the office and, if so, would we report 94620 and get paid?


South Dakota Subscriber

Answer: You should report six-minute walk tests in the same manner regardless of location, as long as your physician appropriately documents the measurements required for reporting the service. When your pulmonary function technologist performs the six-minute walk test in a private office setting (POS 11) in which the physician owns the equipment and provides the interpretation and report, bill the global code: 94620 (Pulmonary stress testing; simple [e.g., prolonged exercise test for bronchospasm with pre- and post-spirometry]).

Caution: If the documentation doesn't support reporting 94620 and the technologist measured multiple oxygen saturations, you should use 94761 (Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations [e.g., during exercise]). You can only use this code only if your physician provided no other billable service on the same day. 

Answers for You Be the Coder and Reader Questions were reviewed by Kathy Pride, CPC, CCS-P, a coding consultant for QuadraMed in Port St. Lucie, Fla.; and Bruce Rappoport, MD, CPC, a board-certified internist who works with physicians on compliance, documentation, coding and quality issues for Rachlin, Cohen & Holtz LLP, a Fort Lauderdale, Fla.-based accounting firm with healthcare expertise.