Pulmonology Coding Alert

Reader Question:

Flow Volume Loop and Spirometry

Question: How do I receive reimbursement for billing a flow volume loop (94375) when a spirometry (94010) is performed?

Maureen Stapleton
Lancaster, Pa.

Answer: Code 94375 (respiratory flow volume loop) will always be denied when billed with code 94010 (spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation).

According to the national Correct Coding Initiative (CCI), version 6.0, code 94375 is bundled into code 94010. The CCI has assigned modifier status 0 to code 94375, which means that no modifier can ever be applied to code 94375 that will allow for its reimbursement.

Editor's note: Carol Pohlig, CPC, R.N., a reimbursement analyst for the office of clinical documentation in the department of medicine at the University of Pennsylvania, Department of Medicine in Philadelphia, answered this question.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more