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94150 vs. 94200

  1. Default 94150 vs. 94200
    Medical Coding Books
    I work for Pediatricians who sometimes need to do a Peak Flow measure on children before and after medications are administered. 94150 (Vital capacity, total) is routinely being denied as included in 'another' service. Should we, perhaps, be using 94200 (Maximum breathing capacity, maximal voluntary ventilation), or should I modify 94150 somehow?

    Thanks for your input!

    Pamela

  2. Default
    What services are you billing this with? E/M or preventive care visits probably need a modifier 25. Still no guarantee they won't be bundled though.

  3. #3
    Default
    You could try the 25 modifier on the E/M but we don't have any payers that reimburse for a peak flow no matter what - modifier or not. It is considered included in the visit or other service provided that day.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I, AAPC Fellow
    AHIMA Approved ICD-10-CM/PCS Trainer
    AAPC National ICD-10-CM Trainer

  4. Default Thanks
    Thank you both for the information. We have tried using the -25 modifier, but it doesn't seem to make a difference.

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