In the medicine section, CPT 2010 lists several codes for spirometry testing under ‘other procedures’. The next time you are faced with determining the best code for a patient, see to it that you know the differences between these most common options and which codes you do not need to include on your claim.
Report 94010 as your first choice
While coding spirometry, the most common choice for most pediatricians is 94010.
The situation: An established patient presents for a follow-up visit after an episode of respiratory distress where she required a nebulizer or inhaler treatment. The staff evaluates the child’s respiratory status at that visit and tends to the child. You use 94010 along with an E/M code for the office visit; according to experts, the child’s significant subsequent management merits 99214.
Modifier tip: When the pediatrician completes a service in addition to evaluation/management care, payers often require you to append modifier 25 to the evaluation/management code. Including modifier 25 with 94010 and 94016 is unnecessary.
Supervision status: Code 94060 calls for direct supervision. See to it that a doctor is present in the office suite and is readily available to furnish assistance and direction throughout the procedure.
Watch for chances to report 94664
Patients who make use of inhalers on a regular basis need to know that they are using the equipment right, especially when you are dealing with children. If the child drops in for a regular visit, enquire how they use the inhaler. Show them how to use it properly if required and go for 94664.
For more on common spirometry tests, sign up for a one-stop medical coding website. Onboard such a site, you can go for a CPT Assistant (http://www.supercoder.com/coding-references/code-connect)tool and stay informed.
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