Why Should I be Doing Spirometry Testing?
Chronic obstructive pulmonary disease (COPD) Facts:
- COPD is the 3rd leading cause of death in the USA
- An individual dies every 4 minutes of COPD in the United States
- The best single test for detecting early COPD is a breathing test called spirometry
- Treatment is more effective if given before symptoms occur
Spirometry Testing is Important!
Asthma Facts
- Asthma accounts for one-quarter of all emergency room visits in the U.S.each year.
- With 2 million emergency room visits Asthma is the #1 cause of school absenteeism among children
accounting for more than 14 million total missed days of school.
- An estimated 20 million Americans suffer from asthma (1 in 15 Americans).
Clinical Indications:
- Evaluation of Smokers over the age of 45
- Dyspnea (shortness of breath)
- Chronic Cough
- Chest Tightness or Cough with Exercise
- Frequent “Colds” or “Hay Fever”
- Dust or Chemicals Inhaled at Work
- Pre-surgical Testing
- Staging an Acute Asthma Attack
- Documentation of Pulmonary Disability
- Management of Patients Receiving Bronchodilators
- Monitoring Congestive Heart Failure
ICD-9 Coding
| Indication |
ICD9-CM Code* |
| Shortness of Breath |
786.05 |
| Cough |
786.2 |
| Chronic Bronchitis |
497.x |
| Emphysema |
492.x |
| Asthma |
493.x |
| COPD |
496.x |
| Pre-operative Respiratory Exam |
V72.82** |
| History of Tobacco Use |
V15.82** |
| Bronchitis due to chemical fumes or vapor |
506.x |
| Special screening for other and unspecified respiratory conditions |
V81.4 |
| Encounter for therapeutic drug monitoring |
V58. |
* Codes should always be assigned to the highest level of specificity
** Should not be assigned as principal diagnosis
CPT Coding
| Code |
Description |
Average
Reimbursement |
| 94010 |
Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation |
$33.00 |
| 94014 |
Patient intiated spirometric recording per 30 day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and physician review and
interpretation. |
$43.00 |
| 94015 |
Patient recorded spirometry; Recording (includes hook-up, reinforced edication, data transmission, data capture, trend analysis, and periodic recalibration) |
$23.00 |
| 94016 |
Patient recorded Spirometry; Physician review and interpretation only |
$25.00 |
| 94060* |
Bronchospasm evaluation: spirometry as in 94010, before and afater bronchodilator (aerosol or
parental) |
$57.00 |
| 94200 |
Maximum breathing capacity, maximal voluntary ventilation |
$22.00 |
| 94375* |
Respiratory flow volume loop |
$37.00 |
| 94620 |
Pulmonary stress testing; simple (eg, prolonged exercise test with pre- and post-spirometry) |
$65 |
* Codes most commonly used in primary care
Visit our ndd Spirometery page on our website for a variety of ways to use Spirometry!
ndd Medical EasyOne Plus Diagnostic Spirometry System
ndd Medical EasyOne Plus Frontline Spirometry System
Spirometry and Reimbursement
Who to Test
Spirometry should be performed on all people 45 or older who currently smoke, are former smokers, or who are regularly exposed to environmental tobacco smoking or workplace irritants such as grain dust or cotton fibers. Testing should also be done in anyone with chronic cough, excess mucious, dyspnea on exertion or wheeze. In addition, anyone with a family history of emphysema or chronic bronchitis should have a spirometric test as a part of their database.¹
Spirometry is essential to the diagnosis and management of asthma. The Expert Panel recommends that a spirometry test be done at the initial assessment, after treatment has stabilized and at least every 1-2 years when asthma is stable, more often when asthma is unstable or at another time the clinician believes it is needed.²
CPT
Codes |
Description |
Average
Reimbursement |
| 94010 |
Spirometry,
including graphic record, total and timed vital capacity, expiratory
flow rate measurement(s), with or without maximal voluntary ventilation. |
$33.00 |
| 94375 |
Respiratory
flow volume loop |
$37.00 |
| 94060 |
Bronchospasm
evaluations: spirometry as in 94010, before and after bronchodilator
(aerosol or parental) |
$57.00 |
Return on Investment³
Tests
per Week |
1
Year Revenue |
5
Year Revenue |
| 3 |
$6,396.00 |
$31,980.00 |
| 5 |
$10,660.00 |
$53,300.00 |
| 10 |
$21,320.00 |
$106,600.00 |
| 15 |
$31,980.00 |
$159,900.00 |
¹ National Lung Health Education Program
² National Asthma Education and Prevention Program
³ Based on Average Reimbursement of $41.00
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