Pulmonology Coding Alert

Question: Our pulmonologist orders a methacholine challenge test on a patient at the local hospital. The notes indicate that the pulmonary function technologist (PFT) performed three spirometric determinations to determine the effects of the test. How should I report this encounter? Can I report the spirometries separately? Minnesota Subscriber Answer: No, you should not report the spirometries separately. You'll report the code for post-challenge test spirometries once per claim. On the claim, report the following: • 95070 (Inhalation bronchial challenge testing [not including necessary pulmonary function tests]; with histamine, methacholine, or similar compounds) for the test • 94070 (Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents [e.g., antigen(s), cold air, methacholine]) for all of the spirometries the PFT performs to check the effect of the methacholine • J7674 (Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg) for the methacholine supply used during challenge testing. Modifier alert: When performed in a hospital-based PFT lab, link modifier 26 (Professional component) to 94070 to show that you are only billing for your physician's services. The lab will report 94070-TC (Technical component).