Is 94060 (Current Procedural Terminology) the correct code for a full Pulmonary Function Test (PFT)?

CPT Coding for Pulmonary Function Testing

No, 94060 is not the correct CPT code for a full Pulmonary Function Test (PFT). According to the American Heart Association guidelines, 94060 is specifically for reading and interpreting a pulmonary function test, not for performing the complete test itself 1.

Correct CPT Codes for Pulmonary Function Testing

• For a complete pulmonary function test, the appropriate codes depend on the specific components and complexity of testing performed:

  • 94621 is the code for complex pulmonary stress testing, which includes metabolic cart measurements of VO2 and VCO2 1
  • 94620 is the code for simple pulmonary stress testing (telemetry and pulse oximetry-monitored testing) 1

• The 94060 code specifically refers to reading and interpreting a pulmonary function test, not performing the complete test 1

Components of Pulmonary Function Testing and Their Codes

• For spirometry components:

  • 94010: Simple spirometry without bronchodilator 1
  • 94060: Reading and interpretation of a pulmonary function test 1
  • 94070: Spirometry with post-exposure bronchospasm 1

• For additional measurements that may be part of a complete PFT:

  • 94681: Oxygen uptake, expired gas analysis (CO2 output, O2 percentage) 1
  • 94761: Pulse oximetry with multiple determinations 1

Coding Requirements and Documentation

• Complete PFTs require specific documentation in the medical record to support the test and any adjunct procedures 1

• For complex pulmonary testing (94621):

  • Direct physician presence and supervision is required throughout the entire test 1
  • Must include metabolic cart measurements 1

• For simple pulmonary testing (94620):

  • Only requires general physician supervision and control 1
  • Does not require physical presence of the physician 1

Bundling Considerations

• The Correct Coding Initiative (CCI) bundles certain codes when procedures are typically performed together 1

• Spirometry codes (94010,94060,94070) are typically bundled with pulmonary testing codes 94620 and 94621 1

• If both pulmonary and cardiac measurements are performed during the same test, CPT code 93018 should be added to either the simple or complex pulmonary testing codes 1

Common Coding Pitfalls

• Using 94060 alone when a complete PFT is performed is incorrect and may result in improper reimbursement 1

• Failing to document medical necessity with appropriate ICD-9/ICD-10 diagnostic codes can lead to claim denials 1

• Not generating separate interpretive reports when billing for multiple components can result in payment issues 1, 2

• Not recognizing when additional codes are needed for arterial blood gas measurements (36600,36620,82803) that may be part of comprehensive testing 1

For accurate billing and proper reimbursement, it's essential to use the correct CPT codes that reflect the specific components and complexity of the pulmonary function testing performed, with 94621 being the appropriate code for a complete complex PFT with metabolic measurements.