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Pulmonology Coding Alert

Reader Questions:

Remember Whose Equipment You're Using On Spirometry Claims

Published on Sun Sep 17, 2006

Question: Our pulmonologist ordered a spirometry on one of our patients at the hospital. I reported 94010 and received a denial. What did I do wrong?


Nebraska Subscriber


Answer: You probably got the denial because the procedure was performed in a hospital.

When your pulmonologist orders spirometry in a facility setting and interprets the test, you're only allowed to report the professional component of the code, even if you own the equipment.

Do this: The next time your physician interprets a spirometry in a facility setting (for example, place of service 21 or 22):

• report 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation) for the procedure

• attach modifier 26 (Professional component) to 94010 to show that you are only billing for your pulmonologist's service, not the technical portion. For this encounter, the hospital will bill for the technical component of 94010.
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