Billing For Pulmonary Procedures
For your convenience, below is a chart listing specific pulmonary procedures and their corresponding CPT
codes that can be used as a quick reference when billing for asthma care services.
|Pulmonary Function Testing—no bronchodilator
|Pulmonary Function Testing pre and post bronchodilator
|Aerosol treatment (includes demonstration)*
The specific pulmonary services and physician responsibilities listed in the chart above are described below:
The code for aerosol treatment includes aerosol demonstration. If the demonstration is provided separately,
it can be billed as a separate service with adequate documentation and use of the modifier 59 to alert the payer
that it is a distinct and separate service. Always consult the payer’s billing and payment rules.
Pulmonary Function Testing:
Spirometry is a critical component for diagnosing and managing pulmonary disease.The test allows the physician
to evaluate the degree of airway obstruction, the effectiveness of the current therapy, and gives the opportunity to
customize medications to ensure adequate daily control.Test results are available immediately following the procedure
for evaluation and interpretation.
Scheduling, interpretation of the PFT, nebulizer set-ups, compressor, liquid or inhaled albuterol for inhalation,
and normal saline is supplied by the physician’s office. Most payers cover this service.
During this session patients should be taught and expected to adequately demonstrate inhaler and spacer
technique. Patients should bring their inhaler and spacer with them for teaching. This takes approximately 15
minutes. Most payers cover education and training, but they may not allow it to be reimbursed separately if it is
provided with other services. You should consult the payer’s billing and payment rules.
The physician is responsible for scheduling the appointment and for prescribing the medication(s) and spacer
for the patient. Most payers cover spacers. They may be covered as a pharmacy benefit, or may be considered
durable medical equipment.
This simple and painless procedure is done to evaluate oxygen levels of the patient. It is recommended for any
patient that is in respiratory distress. For a patient that suffers with COPD, oximetry while walking may be
required. Most payers cover this service.