Wiki 6 minute walk test

[merandacancilla]

Hi everyone: I need help with the coding for a 6 minute walk test.

It was suggested to me to use CPT code 94618-Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed.

From that definition it sounds good but my Optum 360 Encoder Software has some information in the description that has me concerned.

It says

In 94618, a pulmonary exercise stress test is performed to determine how much air is moving in and out of the lungs during exercise and to establish where breathing problems are occurring, since they may be in the lungs, heart, or circulation. An exercise stress test is done with the patient riding a stationary bike (ergometer) or walking on a treadmill. Heartrate, breathing, and blood pressure are monitored before beginning the exercise. Basic ventilation studies are performed with a spirometer and recording device as the patient breathes through a mouthpiece and connecting tube while a nose clip prevents nasal breathing. Measurement of the patient's oxygen level by pulse oximetry is included, as well as oxygen titration and heartrate, when performed. In 94621, cardiopulmonary exercise testing is performed. Electrodes are placed on the upper body to monitor the heart. Throughout the process, blood samples may be taken to measure oxygen uptake and carbon dioxide waste products in the blood, as well as other tests including minute ventilation and an electrocardiogram (ECG, EKG).

I know they are just having the patient walk up and down the hallway in the office and measuring a pulse ox and maybe heart rate.

They aren't using a spirometer or mouthpiece for the patient to breathe through and be recorded by any type of electronic equipment.

They are performing the test to "Certify the patient's need for supplemental oxygen."

Thank you in advance for any help!

 

[CBLENNIE]

I don't see how the patient walking up and down the hall for 6 minutes any measuring pulse ox and heart rate would qualify for 94621. It looks like 94618 - Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration (short description in Encoder Pro), when performed, is closer to what your practice is doing.

However, Encoder Pro's long description may still create some doubts about what your practice is doing qualifies, as it states:

In 94618, a pulmonary exercise stress test is performed to determine how much air is moving in and out of the lungs during exercise and to establish where breathing problems are occurring, since they may be in the lungs, heart, or circulation. An exercise stress test is done with the patient riding a stationary bike (ergometer) or walking on a treadmill. Heartrate, breathing, and blood pressure are monitored before beginning the exercise. Basic ventilation studies are performed with a spirometer and recording device as the patient breathes through a mouthpiece and connecting tube while a nose clip prevents nasal breathing. Measurement of the patient's oxygen level by pulse oximetry is included, as well as oxygen titration and heartrate, when performed.

Your practice may need to expand on what their version of the 6-minute walk test in order to qualify for billing 94618 but it may be worth it financially for your practice to step up their 6-minute walk testing procedure so that it meets the requirements to bill 94618.

It should go without saying but the service also needs to be medically necessary in order to bill for it.