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Modifiers for Pulmonary Function Testing

Denise Posted Thu 21st of June, 2012 17:15:56 PM

When billing the multiple components of a pulmonary function test,
do I use a 51 modifier on the lines other than the first? (Plus the
26 modifier)...

SuperCoder Answered Fri 22nd of June, 2012 20:22:43 PM

CPT code 94060 (bronchospasm evaluation; spirometry as in 94010, before and after bronchodilator [aerosol or parenteral]) includes the following codes:

•94010 (spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation)
•94200 (maximum breathing capacity, maximal voluntary ventilation)
•94375 (respiratory flow volume loop)
•94640 (nonpressurized inhalation treatment for acute airway obstruction)
•94650 (intermittent positive pressure breathing IPPB) treatment, air or oxygen, with or without nebulized medication; initial demonstration and/or evaluation)
•94664 (aerosol or vapor inhalations for sputum mobilization, bronchodilation, or sputum induction for diagnostic purposes; initial demonstration and/or evaluation)
•94770 (carbon dioxide, expired gas determination by infrared analyzer )

-->Bill all other CPT codes for the pulmonary function test distinctly. Append modifier -26 if services are carried out in a hospital and your physician is giving a written interpretation and report.

If the payer you are reporting to requires it, add modifier 51 to the appropriate codes. Most payers no longer require modifier 51, however, so we have not included it here.

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