Otolaryngology Coding Alert

When you report 94060 in 2005 for your allergist's bronchospasm evaluation services, you'll need to know whether the physician assessed the patient's "responsiveness" to accurately report the evaluation.
 
CPT 2005 overhauls 94060 and 94070 to help improve the accuracy of your bronchospasm claims.
 
"Previous descriptions indicated that they were both 'bronchospasm evaluations,' " which may have confused coders who were not familiar with the services, says Carol Pohlig, BSN, RN, CPC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia. Here are the revised code definitions:

94060 - Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration

94070 - Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (e.g., antigen[s], cold air, methacholine). Revisions Won't Change the Way You Code Take note: The way you report the codes remains the same, however. If, for instance, spirometry (94010, Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurements[s], with or without maximal voluntary ventilation) reveals that the patient has decreased lung function, which may indicate asthma (493.xx), the allergist may administer a bronchodilator. The bronchodilator relaxes the patient's bronchial tubes and allows the physician to retest the patient's pulmonary function.
 
For this service, you should assign 94060, but not 94010. Code 94060 includes the basic spirometry code, as the definition specifies, says Beverly Roy, CPC, CCP, a professional coder with Summit Medical Associates in Hermitage, Tenn.
 
Occasionally, an allergist performs a methacholine challenge test to determine the breathing disorder when the spirometry results are normal. Typically, the physician bills 94070 when he also uses a pulmonary function test (PFT) to measure a methacholine challenge's impact.
 
"The new descriptions make it more clear and precise as to what is actually being evaluated and by which method," Pohlig says.

CPT Deletes Jet Injections - Again In other news, CPT also revised immunization administration codes 90471 and 90472 so they no longer include jet injections. The move is part of CPT's continuing effort to delete jet injection from a number of immunization codes. Look for these revised 2005 descriptors:

90471 - Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); one vaccine (single or combination vaccine/toxoid)

+90472 - ... each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure).  Roy's office uses 90471 to report flu, pneumonia and other vaccinations when the patient has private insurance. And for each additional injection, she bills 90472, she says.