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Pulmonary Function Tests Coding: A Complete Guide

A Professional show about the Pulmonary Function Tests.

Pulmonary Function Tests (PFTs) are important in diagnosing and managing breathing conditions. These tests compare lung features and help detect, evaluate, and track sicknesses like allergies, chronic disruptive pulmonary disorder (COPD), and different respiratory issues. Proper coding for PFTs is important for the correct medical billing process and reimbursement. This blog post will discover the many CPT and ICD-10 CM codes related to pulmonary function tests, providing in-depth expertise to make certain medical billing processes.

CPT Codes for Pulmonary Function Tests

When it comes to coding for Pulmonary Function Tests, there are several key categories to consider. Each category represents a specific type of test used to evaluate different features of lung function.

CPT Codes for Spirometry

Spirometry is one of the most common types of PFTs and measures the volume and speed of air a patient can inhale and exhale. The CPT codes for spirometry include:

  • 94010 – Spirometry, including graphic record, total and timed dynamic capacity, expiratory flow rate measurement(s)
  • 94060 – Bronchodilation sensitivity, spirometry as in 94010, pre- and post-bronchodilator administration
  • 94070 – Bronchospasm provocation test, with spirometry

These codes are essential for capturing the comprehensive evaluation of a patient’s respiratory function

CPT Codes for Lung Volume Testing

Lung volume tests measure the total capacity of the lungs and the amount of air remaining after a full exhalation. The relevant CPT codes include:

  • 94726 – Plethysmography for the resolve of lung volumes and, when performed, airway battle
  • 94727 – Gas reduction or washout for the resolve of lung volumes and, when performed, distribution of ventilation and closing volumes

These tests are vital in diagnosing restrictive lung diseases and ensuring proper patient care.

CPT Codes for Diffusion Capacity Testing

Diffusion capacity testing measures how well smoke such as oxygen pass from the lungs into the blood. The relevant CPT code for this test is:

  • 94729 – Diffusion capacity (e.g., carbon monoxide, membrane) (DLCO)

This code is crucial for identifying issues with gas exchange, a common problem in many respiratory conditions.

CPT Codes for Bronchial Provocation Testing

Bronchial provocation testing is used to assess airway hyperreactivity. The associated CPT codes are:

  • 95070 – Inhalation bronchial challenge testing (not including necessary pulmonary function tests), with histamine, methacholine, or similar compounds
  • 95071 – Inhalation bronchial challenge testing (not including necessary pulmonary function tests), with diluent control or exercise

These codes are often used in diagnosing asthma and other conditions that cause airway sensitivity.

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CPT Codes for Pulmonary Stress Testing

Pulmonary stress tests measure the respiratory system’s response to physical stress or exercise. The related CPT codes include:

  • 94620 – Pulmonary stress testing; simple (e.g., 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration when performed
  • 94621 – Pulmonary stress testing; complex (including measurements of CO2 production, O2 uptake, and minute ventilation)

These tests provide critical information for patients with exercise-induced breathing issues or chronic lung diseases.

ICD-10 CM Codes for Pulmonary Function Tests

To ensure accurate documentation and billing, it’s essential to use the correct ICD-10 CM codes for the diagnoses related to pulmonary function testing. Some of the commonly used codes include:

  • J44.9 – Chronic unhelpful pulmonary disease, unspecified
  • J45.909 – Unspecified asthma, uncomplicated
  • R06.2 – Wheezing
  • R06.89 – Other abnormalities of breathing

These codes correspond to various respiratory conditions and are essential for capturing the clinical reasons for ordering Pulmonary Function Tests.

About Cures Medical Billing Solutions

At Cures Medical Billing Solutions (CuresMB), we recognize the complexities concerned with coding and billing for pulmonary function tests. As a leading family practice billing company, CuresMB is dedicated to imparting specialized billing solutions that cater to the particular desires of family physicians, inclusive of those who often perform and interpret PFTs. Our team of experts ensures that each one of the billing factors, from correct CPT and ICD-10 coding to timely claims submissions and follow-up, is treated with accuracy. By connection with CuresMB, healthcare carriers can focus on turning in fine care to their patients at the same time as we deal with optimizing their revenue cycle. For more info or to discuss your billing need, reach out to us at info@curesmb.com or call us at +1 (917) 994-9941.

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