Part B Coding Coach: Knock The Air Out Of Denials With A New Attack On Spirometry Coding

Why This Topic Matters

Respiratory testing claims are vulnerable to denials when similar procedures are confused, bundled services are reported incorrectly, or inappropriate modifiers and supply codes are appended. The article helps readers recognize the broader coding context and compliance issues involved in spirometry-related billing.

Article Sections

1. 94060 Includes More Than CPT 94010

   Introduces the spirometry code family and explains the general relationship between the primary respiratory testing services discussed in the article. It also frames the distinction between baseline testing and bronchospasm-related evaluation.

2. Watch Out: Similarity to 94640

   Discusses a common point of confusion involving a separate inhalation treatment service and why coders may mix it up with spirometry-related testing. The section focuses on the overlap in the services involved.

3. Use 94070 for a Provoked Response

   Covers the provocation-evaluation category of respiratory testing and places it in context with baseline spirometry and related administered agents. It explains the broader clinical testing scenario associated with this service type.

4. Don't Confuse Challenge Testing

   Addresses another respiratory challenge-testing code family and notes that it belongs in a different context from the spirometry services discussed earlier. The section emphasizes scope and specialty considerations.

5. Be Aware of Spirometry CCI Bundling

   Reviews coding-edit and bundling concerns affecting respiratory testing claims, along with related billing considerations for supplies and drugs. It also touches on modifier and same-day billing issues in this area.

6. Avoid 2 Common Coding Errors

   Summarizes recurring documentation and claim-reporting mistakes seen with spirometry services. The section focuses on repeated-testing scenarios and the risk of overstating the service reported.