CPT® 2012 Update: Streamline Your PFT Reporting

CPT® simplifies reporting by combining two codes into one.

Have you ever struggled with distinguishing between pulmonary function tests for instance carbon monoxide diffusing capacity (DLCO) and membrane diffusion capacity (DMCO)? In case your answer to this is yes, then you’ll be happy to hear that effective Jan.1, 2012, CPT® has reduced your burden by combining these two CPT codes into a single code.

Read on for more on this change and how to adjust your reporting of these tests.

Note Advantages of Single Add-on Code

Before the changes initiated in 2012, you were required to report carbon monoxide diffusing capacity and membrane diffusion capacity using dissimilar CPT codes. This necessitated complex understanding of the procedures as well as knowing the difference between the two codes.

There was rumour that the codes were being reported erroneously since the increase in utilization for 94725 was recognized as 14% more than that of 94720 over a six year time period. Given the limited clinical indications and use for 94725, this surge seemed irrational.

The old CPT codes (prior to Jan, 1, 2012) that have now been deleted include the following:

94720 – (Carbon monoxide diffusing capacity [e.g., single breath, steady state])

94725 – (Membrane diffusion capacity)

Under CPT® 2012, you will be required to report these procedures under a single code:

+94729 – (Diffusing capacity [e.g., carbon monoxide, membrane][List separately in addition to code for primary procedure])

Benefit: This CPT 2012 ( Source "http://www.supercoder.com/cpt-codes/") change has made the job stress-free as there is no need to go into the procedure details to know whether it is a test for carbon monoxide diffusing capacity or membrane diffusion capacity. Both are now reported with single CPT code +94729. The reimbursement and relative value units for the new code (~$53, 1.57 total RVUs) are like 94720.

CPT Code Lookup Tip: As a lot of providers consider DLCO and DMCO to be a routine part of PFTs, they have now been collected together as an add-on code, and cannot be reported on its own. You should therefore report CPT code +94729 together with other pulmonary function tests, for instance:

94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation)

94060 (Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration)

94070 (Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents [eg, antigen[s], cold air, methacholine]) 94375 (Respiratory flow volume loop)

94726 (Plethysmography for determination of lung volumes and, when performed, airway resistance)

94727 (Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes)

94728 (Airway resistance by impulse oscillometry)