Pulmonology Coding Alert

Question: Are codes 94620 (pulmonary stress testing; simple [e.g., prolonged exercise test for bronchospasm with pre- and post-spirometry]) and 94621 (complex [including measurements of CO2 production, O2 uptake and electrocardiographic recordings]) considered diagnostic tests?

Shirley Sykora, Practice Administrator
Suburban Pulmonary & Sleep Associates Ltd., Westmont, Ill.

Answer: Codes 94620 and 94621 are included in the list of non-clinical diagnostic tests per Health Care Financing Administration (HCFA). The list of non-clinical diagnostic tests includes audiology, echo, vascular studies, pulmonary and allergy testing, neurology tests, EEGs, ECG/EKGs, respiratory function tests and cardiac evaluations. See HCFA Carriers Manual, HCFA Publication 14 and related fraud rules in HCFA Publication 14-3, available at HCFAs Web site: http://www.hcfa.gov/pubforms/p2192ch1.htm.

Editors note: Cynthia Thompson, CPC, senior consultant at Gates, Moore & Co., a physician practice management consulting firm in Atlanta, answered this question.