Tiffany Posted Thu 06th of September, 2012 21:35:08 PM
can we bill 94620 and 94010 on the same day
SuperCoder Answered Fri 07th of September, 2012 15:40:16 PM
Common combination would be simple spirometry without bronchodilator, 94010, along with a 6-minute walk, 94620. This pair is in the CCI. As defined , a -59 modifier should be added to the simple spirometry code, 94010-59.
Tiffany Posted Fri 07th of September, 2012 23:26:43 PM
The code description include pre and post spirometry. How is 94010 justified with the use of modifier 59.
SuperCoder Answered Mon 10th of September, 2012 16:55:25 PM
The reason for all the confusion is the CPT descriptor for 94620 (eg, 6-minute walk test, prolonged exercise test for bronchospasm with pre- and post-spirometry and oximetry) ), which describes an exercise-induced bronchospasm test and a six-minute walk test.
There are several simple pulmonary stress tests that you should report using 94620. These include the six-minute walk test and the exercise-induced bronchospasm test.
During an exercise-induced bronchospasm test, the pulmonary function technologist measures spirometry before and after vigorous exercise. The patient exercises on a bicycle or treadmill that induces bronchospasm. This test is totally different than the six-minute walk test that requires the patient to walk as fast as he can for six minutes. During the six minutes, the pulmonary function technologist monitors the patient’s oxygen saturation, heart rate and dyspnea.
The six-minute walk test does not involve spirometry. You should report the test as a simple pulmonary stress test using 94620. The July 2005 CPT Assistant clarifies that you should use 94620 for this test. The walking exercise in the six-minute walk test is not sufficient to induce bronchospasm since its purpose is to evaluate the exercise ability of patients with moderate to advanced lung diseases.
Tip:If your pulmonologist also orders spirometry or spirometry before and/or after the six-minute walk test, you may be able to report it separately from the pulmonary stress test. Many pulmonologists and professional organizations agree that it is separately reportable since this is not a routine part of the six-minute walk test.
In other words, the physician orders spirometry for a separate reason. If this occurs, add modifier 59 (Distinct procedural service) to 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation) or 94060 (Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration) to indicate that the test is a separate test from 94620 and to override the National Correct Coding Initiative edit that includes 94620 with 94010 or 94060.