Pulmonology Coding Alert

Answer: Yes. This is a common combination wherein a simple spirometry without bronchodilator (94010, Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation) is performed along with a 6-minute walk (94620, Pulmonary stress testing; simple [e.g., 6-minute walk test, prolonged exercise test for bronchospasm with pre- and post-spirometry and oximetry]).The Correct Coding Initiative (CCI) bundles these codes, but you can separate this edit by providing supporting documentation and adding modifier 59 (Distinct procedural service)to the column 2 code, which is the simple spirometry code (94010), when appropriate. 

 

You may be confused because of theCPT® descriptor for 94620, which describes an exercise-induced bronchospasm test and a six-minute walk test.There are several simple pulmonary stress tests that you should report using 94620. These include the six-minute walk test and the exercise-induced bronchospasm test.

 

To clarify, the six-minute walk test does not involve spirometry. You should report the test as a simple pulmonary stress test using 94620 as the walking exercise in the six-minute walk test is not sufficient to induce bronchospasm.However, a physician may perform a spirometry test before and after vigorous exercise as part of an exercise-induced bronchospasm test for which 94010 is not separately reported. 

 

Note:If your pulmonologist also orders spirometry or spirometry before and/or after the six-minute walk test, you may report it separately from the pulmonary stress test. This practice is widely accepted because this is not a routine part of the six-minute walk test.