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Pulmonology Coding Alert

Reader Question:

Take Precedence Into Consideration When Coding 94010, 94070

Published on Fri May 27, 2011

Question:My physician wants me to bill separately for a spirogram and methacholine test performed on a patient on the same day. Should I be concerned with any bundles?South Dakota SubscriberAnswer: You may report a spirogram (94010, Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation) and a methacholine test (94070, Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents [e.g., antigen(s), cold air, methacholine]) separately only if the physician performs the spirogram before the methacholine test.Say a patient with dyspnea sees the pulmonologist for a spirogram. After the results have come out normal, the physician decides to perform a methacholine challenge test to determine how responsive the patient's airways are. You would report 94010 and 94070, appending modifier 59 (Distinct procedural service) to the spirometry code.Reminder: The Correct Coding Initiative (CCI) imposes a bundle on 94010 and [...]
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