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Pulmonary Function Tests

  1. #1
    Harrisburg, PA
    Question Pulmonary Function Tests
    Medical Coding Books
    Can anyone help with coding for pulmonary function tests. Prior to January 01, 2012 the pft's were billed as 94010/94060, 94240, 94720, 94260, and 94360. Starting in January three of these CPT's were deleted. The ones I am questioning are 94240, 94260 and 94360. It appears as though 94726 is replacing these codes. I tried to bill medicare using 94726 with three units. Medicare denied stating maximum number of units were exceeded.

    Any help would be appreciated.

  2. #2
    Default Pft
    We worked with our cardiology department to show them the changes and they helped decide on the new code assistnments.

    We code 94240 now to 94727
    94260 to 94727 with add on code 94729

  3. #3
    Harrisburg, PA
    are you getting paid this way?

  4. #4
    Jackson, TN
    DLCO 94720 would now be 94729. As far as 94240,94260, and 94360 the cross walk i have shows it is replaced with 94726 and 94727 however you cant bill these together per CPT. I was also wondering what to bill in replace of these codes if you find a definite answer. 94726 pays more than 94727

  5. #5
    Jackson, TN
    Oh and also the reason you are getting the denial is because you can only bill 1 unit with 94726. It has a MUE of one unit per day

  6. Default 94726 - Body Box (Body Plethsomography)
    Does anyone know if you can bill 97750 with 94726 - we have read that it can be as the 97750 is for measuring performance with an interpretation. We do the body box and interp in the office. However I can only find documentation on the 97750 as it pertains to phsysical therapy. Any help is appreciated.

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