The Current Procedural Terminology (CPT) and HCPCS (Healthcare Common Procedure Coding System) codes (based on the American Medical Association’s Current Procedural Terminology – CPT) as defined below are the most common used to describe spirometry and other procedures performed with the Vitalograph spirometers and other devices.
Description
Spirometry Complete includes graphic record total and timed vital capacity, expiratory flow rate measurement(s) with or without maximal voluntary ventilation
Vitalograph Devices Applicable: Pneumotrac with Spirotrac V; Pneumotrac with ComPAS; Compact Expert; Alpha Touch; In2itive; Alpha; Micro
Bronchodilation Responsiveness spirometry as in 94010, pre- and post bronchodilator or exercise. Spirometry, often referred to as pre/post spirometry, before and after bronchodilator (aerosol) for the purpose of bronchospasm evaluation. This procedure is the same as 94010 with the addition of nebulizer or MDI treatment delivering a bronchodilator and subsequent repeat of spirometry to measure efficacy of treatment. Post spirometry should be performed at least 10 minutes after bronchodilator treatment is completed to give bronchodilator time to reach maximum effectiveness. Cannot be billed at the same visit as 94010.
Pneumotrac with Spirotrac V; Pneumotrac with ComPAS; Compact Expert; Alpha Touch; In2itive; Alpha; Micro
Acknowledgments:
Disclaimer:
The reimbursement information is being provided on an “as is” basis with no express or implied warranty of any kind and should be used solely for your internal informational purposes only. The information does not constitute professional or legal advice on reimbursement and should be used at your sole liability and discretion. All coding, coverage policies and reimbursement information are subject to change without notice. Vitalograph, Inc. does not represent or warrant that any of the information being provided is true or correct and you agree to hold Vitalograph, Inc. harmless in the event of any loss, damage, liabilities or claims arising from the use of the reimbursement information provided to you. Before filing any claims, it is the provider’s sole responsibility to verify current requirements and policies with the applicable payer.
*The material referenced and provided is based upon research current at the time of printing. The final decision of billing for any product or procedure must be made by the provider of care, considering the medical necessity of the services provided, the regulations of insurance carriers and any local, state or federal laws that apply to the services rendered. Vitalograph, Inc. is providing this information in an educational capacity with the understanding that we are not engaged or rendering legal or other professional services or advice. Vitalograph, Inc. does not guaranty Medicare or third-party insurance carrier reimbursement for any of the referenced procedures. Note that applicable laws, rules, and regulations may change. As such, this guide should not be relied upon as a current or comprehensive statement of all applicable laws, rules, and regulations.
**Under Medicare, CPT codes 99453 and 99454 are both practice-expense-only codes. Practice expense is the portion of the resources used in furnishing a service that reflects the general categories of physician and practitioner expenses, such as office rent and personnel wages. There is no physician time or work built into these codes.
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