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Thread: Pulmonary Function test

  1. #1

    Default Pulmonary Function test

    Struggling with the reading of pulmonary functions test. The main componet is either 94010 or 94060 but wondering if there are other componets that could be charged? The report reads as follows.

    The forced vital capacity was 5.25 liters or 98% predicted. FEV1 was 3.49 liters or 82% of predicted. FEF 25/75 was 1.93 lieters or 46% of predicted. Total lung capacity was 7.99 liters or 105% of predicted. The patient had a very mildly diminished residul volume at 80% of predicted. DLCO was actually high at 139% of predicted. The patient demonstrated good cooperation and effort. Flow volume loops are normal. The patient did not receive bronchodilator.

    I know that the 26 modifier has to be added because it is just the interpretation

  2. #2
    Join Date
    Apr 2007
    Location
    Richmond, VA
    Posts
    76

    Default

    The lung volumes (total lung capacity) and the DLCO (diffusion capacity) would also be able to be coded based on the documentation you posted.
    In 2011 -
    94720 for DLCO/Diffusion capacity
    94240 - 94260 - could have been choices for the lung volumes

    In 2012 -
    +94729 for DLCO
    For the lung volumes you would need more documentation stating whether they were done by plethysmography/body box or not, but the choices would be 94726/94727

    Hope this helps...
    Annemarie Lincoln, CPC
    Richmond, VA

  3. #3
    Join Date
    Apr 2007
    Location
    Florida
    Posts
    58

    Default

    The way to bill this correctly would be the following way, for 2012:

    94375-26 - Flow Volume Loop
    94727-26 - Gas dilution or washout for determination of
    lung volumes and, when performed, distribution of
    ventilation and closing volumes
    +94729-26 - Diffusing capacity (eg, carbon monoxide, membrane)
    (List separately in addition to code for primary procedure)

    If your using body box replace 94727 with 94726.

    For 2011:

    94375 - FLow Volume Loop
    94240 - Lung Volumes
    94720 - Diffusing Capacity

  4. #4
    Join Date
    Apr 2007
    Location
    Richmond, VA
    Posts
    76

    Default

    Nelson,

    How did you determine the lung volumes in 2012 would be 94726 without mention of being done via body box or gas washout?
    Also curious why you chose 94375 instead one of the spiro code 94010?

    Just comparing notes to make sure I understand what I was doing :-)

    Thanks!
    Annemarie Lincoln, CPC
    Richmond, VA

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