Pulmonology Coding Alert

Question: I have the CPT codes for the various pulmonary function test (PFT) interpretations. But I need to know if for a complete PFT study there is one code to bill with the modifier -26 (professional component), or should we bill for each procedure? For example, if a patient has complete PFTs (e.g., carbon monoxide diffusion capacity, and spirometry with bronchodilation, plethysmographic method), is there a single code for the complete reading?

Iowa Subscriber

Answer: CPT code 94060 (bronchospasm evaluation; spirometry as in 94010, before and after bronchodilator [aerosol or parenteral]) includes the following codes:

94010, spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation,
94200, maximum breathing capacity, maximal voluntary ventilation,
94375, respiratory flow volume loop,
94640, nonpressurized inhalation treatment for acute airway obstruction,
94650, intermittent positive pressure breathing IPPB) treatment, air or oxygen, with or without nebulized medication; initial demonstration and/or evaluation
94664, aerosol or vapor inhalations for sputum mobilization, bronchodilation, or sputum induction for diagnostic purposes; initial demonstration and/or evaluation
94770, carbon dioxide, expired gas determination by infrared analyzer

Bill all other codes separately. Append modifier -26 if services are performed in a hospital and your physician is providing a written interpretation and report.