Q: Can simple spirometry (handheld) be billed for in the hospital/primary care physician’s office setting? If so what parameters must be documented in order to receive reimbursement? Do you need to document pre and post spirometry results to bill?
A: Simple spirometry to me is CPT 94010. The code is listed as: Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation. The section header in the CPT book indicates that the procedure requires an interpretation of the test results. CPT 94060 is for brochodilation responsiveness and is defined as spirometry as in 94010 pre-and post-bronchodilatilator administration. The two tests (pre and post) as defined in code 94010, along with interpretation of the results by the provider, would need to be documented to bill this code.
Jill M. Young, CPC, CEDC, CIMC, is president of Young Medical Consulting LLC in East Lansing, Mich.
Reimbursement rates and CPT codes are subject to change based on region and updates to regulations. ADVANCE’s Coding Q&A column is a guide only – check the specific coverage in your area to ensure accuracy.
