6 minute walk, 94761 vs 94620


Jackson, WI
Best answers
Hi, I am new to Pulmonary coding , I have read all the threads on this forum regarding the 6 minute walk performed with spirometry with bronchodilator vs 94761. I have a question regarding how this should be coded? I receieved an email from another coder as to how she bills this service.

"94620 Simple Pulmonary Stress Test is a 6 minute walk test with pre/post spirometry and oximetry as the CPT book reads. If a provider uses 94060 and 94761, we change that to 94620 because that is the description above for the Simple Pulmonary Stress Test"

I have read many articles and researched the web, I can't find anthing that supports changing the codes.

Exercise Testing
Pulmonary exercise testing has 2 CPT codes available:
simple (CPT code 94620, APC 0368) and complex
(CPT code 94621, APC 0369). In general, both procedures
should quantify exercise tolerance and measure
cardiorespiratory responses to the exercise. The difference
between the two is that the latter involves analysis
of exhaled gas (oxygen consumption and carbon dioxide
production). If arterial blood gas analysis is performed,
the blood-draw and analysis can be billed separately
(CPT code 36600 for arterial sampling, 82803 or analysis with calculated arterial oxygen saturation,
82805 for analysis with measured arterial oxygen saturation).
In contrast, multiple pulse oximetry assessments
(CPT code 94761) during exercise can be billed but
have a $0 Medicare payment. Separate billing for electrocardiograph
rhythm strips (CPT 93040) can also be
done, but a full 12-lead electrocardiograph response to
exercise has a separate exercise testing CPT code (CPT
codes 93017 or 93015). Of note is that there are many
other CPT codes for specific exhaled gas analyses. These,
however, generally edit out with the complex exercise
test code.
The 6-minute walk test has been a subject of controversy
as to how it should be billed. Physical therapists
have been billing for it for a number of years (CPT code
97750), but doing so requires the services of a licensed
physical therapist, and they are generally unavailable in
pulmonary function laboratories. A common pulmonary
function laboratory practice is to use the CPT code 94620
(simple exercise test) for the 6-minute walk test. To use
this CPT code, however, it would probably be prudent to
measure 1 or 2 cardiorespiratory variables (eg, heart rate,
pulse oximetry) in addition to noting the exercise tolerance.

Sorry for the long post, but I know there has to be a pulmonary coder that can help!

Thanks a bunch!!!