If your physician is reading and interpreting the PFT with report/findings, then 94010-26 would be appropriate. If you are billing 94010-26, you may NOT then count it toward data on E/M leveling.
If your physician is reading and more informally interpreting the PFT without a report but still noting their evaluation of the test, then I would not recommend billing 94010-26. In this scenario, it can be counted toward data on E/M leveling as independent interpretation.
Independent interpretation: The interpretation of a test for which there is a CPT code and an interpretation or report is customary. This does not apply when the physician or other qualified health care professional is reporting the service or has previously reported the service for the patient. A form of interpretation should be documented but need not conform to the usual standards of a complete report for the test.
If your physician is reviewing the PFT without independent interpretation, then I would count it for E/M leveling as review of a test.
For you last scenario, read and interpret PFT without a visit, if he is providing a complete report, then 94010-26 could be used.
For tests (not PFTs, but imaging) I will note that my physicians usually read the report, occasionally do independent interpretation, but never with their own report in order to consider -26. I don't know carrier policies, but my initial instinct is to question the medical necessity of a second physician to read and report on a PFT.
I hope that helps better explain it.
