Resolved Billing and Coding for 94640 & 94010

[AshaG_61313]

I work for a Family Practice and we are having alot of issues when Billing the 94640 & 94010. We bill with different dx codes for each CPT code and the insurance carriers pay the 94010 & deny the 94640 or request Medical records and still deny. What is the best way to bill when billing these two codes together? Any help is appreciated with this.

 

[Lori]

Here is a great article on that code billing

94060 includes the administration of the bronchodilator. The parenthetical notes below this code state that the bronchodilator supply/medication can be reported separately. To append a modifier to 94640 means that the inhalation treatment is separate and distinct from the performance of the bronchodilation responsiveness test.

Q&A: Should we add a modifier for bronchodilation services? - www.hcpro.com

Q: Our respiratory department performs a test where they have patients perform a spirometer test, give them a bronchodilator, and perform the spirometry again. They have been charging CPT® codes 94060 (bronchodilation responsiveness, spirometry as in 94010, pre- and post- bronchodilator...

www.hcpro.com

 

[AshaG_61313]

Thanks Lori I really appreciate your help!