Pulmonology Coding Alert

Question: When our physician performs a plethysmography, we code it 93720. However, lately the insurance company hasnt been paying. How should we bill?

California Subscriber

Answer: Be clear that you are using 93720 (plethysomography, total body; with interpretation and report) at the appropriate time. The code describes a diagnostic pulmonary evaluation that measures thoracic gas volume, compliance of the lung, airway resistance and airway conductance. It should be used when the physician:

1. performs the testing;
2. supplies the equipment and technician; and
3. provides a written interpretation of the plethysmography report.

Code 93721 (... tracing only, without interpretation and report) should be used by the facility providing the equipment and technician when it is a separate entity from the practice.

When the doctor is providing the separate interpretation of the test that is performed on the equipment owned by an independent facility, then he or she should bill 93722 (... interpretation and report only).