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Description
  
  • Billing codes and reimbursement for simple spirometry vary by state.
  • This summary of ICD-9 and CPT codes is provided only as a guide. Always check with your specific payor for the appropriate use of the CPT and ICD-9 codes.
  • The physician fee schedule values listed are based on national averages and specific payments may vary geographically. Codes and rates are subject to change.

Codes:

  • Spirometry without bronchodilator: CPT code 94010
  • Pre- and post-bronchodilator spirometry: CPT code 94060
  • When flow volume loop is performed: CPT code 94375
  • Can bill for bronchodilator administration: CPT code 94664

ICD-9 codes for symptoms, disease, etc. are needed in conjunction with CPT codes. Below are the most commonly used:

  • Chronic Cough (786.2)
  • Dyspnea (786.09)
  • Bronchitis (491.0)
  • Mucopurulent chronic bronchitis (491.1)
  • COPD (496.0)
  • Restrictive lung disease (518.89)
  • Asthma (493.90)
The national average reimbursement (2013) for spirometry:
  • Spirometry without bronchodilator - $37
  • Pre- and post-bronchodilator spirometry - $64
  • When flow volume loop is performed - $40
  • Bronchodilator administration - $19

National Average Medicare Physicians Fee Schedule Amounts: 70 Fed. Reg 681 32-68215 (2013)