Pulmonology Coding Alert

Question: We perform lung volumes and diffusion capacity in our office, as well as spirometry. I bill the following codes: 94260 (thoracic gas volume), 94360 (determination of resistance to airflow, oscillatory or plethysmographic methods) and 94720 (carbon monoxide diffusing capacity, any method). Can code 94010 (spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation) or 94060 (bronchospasm evaluation: spirometry as in 94010, before and after bronchodilator [aerosol or parenteral]) be billed in addition, if it is done on the same day?

Darla Brown
Lung and Chest Medical Associates, Spartanburg, S.C.

Answer: These tests are not bundled into a single, larger procedure. Bill each individual test that is performed. You can bill spirometry (94010) or bronchospasm evaluation (94060) (but not both) separately from the tests you mention. Remember that if a separate, identifiable evaluation and management service is done on the same day, it should be reported in addition to the pulmonary testing codes. Some carriers may require a -25 modifier to indicate that a significant level of evaluation and management service has been provided.

Editors note: Susan Callaway-Stradley, CPC, CSS-P, an independent pulmonology coding consultant and educator in North Augusta, S.C.; Cynthia DeVries, RN, BSN, CPC, coding coordinator with the Lee Physician Group, a 42-physician practice in Ft. Myers, Fla.; and Laura Siniscalchi, RRA, CCS, CCS-P, CPC, education coordinator at Beth Israel Deaconess Medical Center in Boston, provided advice to help answer these questions.