Pulmonology is the sub-field of medicine known for concentrating only on respiratory circulation as its primary study area. The pulmonary system, also called the respiratory system, comprises the lungs, the trachea, the bronchi, the bronchioles, the blood vessels that connect them, and everything else that has to do with breathing and the process of breathing (gas exchange).
The number of patients with pulmonary conditions and lung illnesses that pulmonology physicians encounter is growing significantly. This necessitates an immediate requirement for a deeper comprehension of the CPT codes for pulmonary treatments and the correct reporting of these treatments. As a result, physicians can maintain compliance and prevent payment concerns in the long run.
This article aims to give pulmonologists a thorough list of CPT codes for pulmonology billing and coding to help them ensure appropriate coding and payment for their services. See the complete list of pulmonology CPT codes below.
Also: CPT codes for urgent care
Common CPT Codes for Pulmonology
The most prevalent pulmonology CPT codes are listed below.
- 94010: Expiratory flow rate (EFR), vital capacity (VC), and a graphical representation of these variables (with or without maximal voluntary breathing) are all components of spirometry.
- 94620: When performing pulmonary stress testing (such as the 6-minute walk test), taking blood pressure, pulse oximetry readings, and titrating the patient’s oxygen levels is standard practice.
- 94726: When carried out, lung capacity can be measured using nitrogen washout or helium dilution.
- 94728: Before and post-exercise spirometry and pulse oximetry to diagnose bronchospasm
- 94729: The use of impulse oscillometry for quantitative evaluation of airway resistance
- 94750: Chest computed tomography (CT) scan without contrast medium.
- 94760: Oxygen saturation is measured non-invasively using ear oximetry or pulse oximetry, quantified once
- 95012: testing for bronchial challenges using histamine, methacholine, or a comparable substance
- 96401: Administration of chemotherapy subcutaneously or intramuscularly; nonhormonal anticancer agents
- 96402: hormone-based antineoplastic chemotherapy administered subcutaneously or intramuscularly
- 96413: Treatment using a single chemical or substance for up to an hour via intravenous infusion (chemotherapy).
- 96415: Administration of chemotherapy, intravenous infusion method; extra hour, a separate procedure
- 96523: Drug delivery systems that use irrigation of implanted venous access devices
- 99203: New patient evaluation in an office setting or other outpatient setting requires a thorough history, thorough medical assessment, and moderately sophisticated medical decision making
- 99213: Any encounter between a healthcare provider and an established patient that takes place outside of an inpatient setting and includes a medically necessary history and physical examination
- 99214: A visit to a doctor’s office or other outpatient settings to diagnose and treat an established patient involves considerable medical decision-making and a thorough history and physical assessment.
Spirometry
[CPT Code 94010]
Spirometry evaluates a patient’s lung function by measuring their lung volume and respiratory rate. Spirometers, a tool used in this test to gauge lung function and capacity, are used to conduct it.
Billed using CPT code 94010, spirometry services consist of taking the patient’s vital capacity measurements, timing those measurements, and then plotting the results graphically. Both the initial and follow-up spirometry tests can be performed using this code.
Tests for Pulmonary Stress
[CPT Code 94620]
The effectiveness of a patient’s cardiovascular system and lungs during exercise is assessed through pulmonary stress testing, commonly known as exercise testing. The subject’s vital signs (heart rate, oxygen levels, and oxygen titration) are monitored while they engage in physical activity such as walking or running.
Patients who experience respiratory distress during exercise, such as shortness of breath or chest pain, are frequently assigned this code.
Measurement of Lung Volume
[CPT Code 94726]
A lung volume measurement procedure is performed to gauge how much air is in a patient’s lungs. When billing for lung volume measurement with either a nitrogen washout or helium dilution technique, the CPT code 94726 should be utilized. This code is often used for people with respiratory problems, such as chronic obstructive pulmonary disease (COPD) or lung surgery.
Test for Bronchospasm During Exercise
[CPT Code 9472]
A patient’s ability to experience bronchospasm in response to physical activity can be determined with the help of an exercise test for bronchospasm.
This service is billed using CPT code 94728, which incorporates pre- and post-spirometry and oximetry. Usually, people with symptoms like wheezing or shortness of breath when exercising utilize this code.
Measurement of Quantitative Airway Resistance
[CPT Code 94729]
A quantitative airway resistance measurement assesses a patient’s airway resistance. This service, which includes measuring airway resistance by impulse oscillometry, is billed using CPT code 94729. This code is often used for patients with asthma or other lung illnesses.
A Chest CT Scan
[CPT Code 94750]
A chest CT scan assesses the organs in a patient’s chest, including the heart and lungs. This service is billed using CPT code 94750 and comprises a computerized axial tomography (CT) scan of the chest without contrast material. Patients with symptoms including coughing, chest pain, or difficulty breathing are often assigned this code.
Pulse oximetry or Non-invasive Ear
[CPT Code 94760]
Pulse and ear oximetry are non-invasive measurements of patient oxygen saturation. The non-invasive ear or pulse oximeter is used to determine oxygen saturation as part of the CPT code 94760 service. Patients experiencing symptoms like breathing difficulties or low oxygen saturation levels are frequently assigned this code.
Testing for the Bronchial Challenge
[CPT Code 95012]
Bronchial challenge testing is performed to gauge how receptive a patient’s airways are. This service uses a bronchial challenge agent like histamine or methacholine and is billed using CPT code 95012. This code is used for patients with asthma or other respiratory illnesses.
Chemotherapy Management
[96401, 96402, 96413, and 96415]
It is common practice for doctors to provide chemotherapy to patients who have cancer and other illnesses. When billing for services related to chemotherapy treatment, the CPT codes 96401, 96402, 96413, and 96415 are utilized.
These codes comprise non-hormonal antineoplastic medication administered by subcutaneous or intramuscular injection (96401), hormonal antineoplastic drug administration (96402), and chemotherapeutic drug intravenous infusion (96403). (96413 and 96415). These codes are often used for people who have cancer or other diseases that necessitate chemotherapy.
Implantation of a venous access device irrigation
[CPT code 96523]
A medical procedure called irrigation of an implanted venous access device is used to keep a catheter’s patency after it has undergone surgery to give long-term venous access to patients undergoing chemotherapy, intravenous fluids, or blood products.
This service, which involves changing the dressing and flushing the catheter, is billed using CPT code 96523. Patients with venous access devices usually use this code.
Conclusion
Correctly assigning codes allows pulmonologists to provide the best possible treatment for their patients while receiving fair payment. Maintaining current CPT code changes is essential in the ever-changing world of medicine. So, let’s continue educating ourselves and giving our patients the finest care possible.