tci ED Coding & Reimbursement Alert - 2009 Issue 3

Reader Questions: Combo Codes Mark COPD With Other Conditions

Question: The ED physician treats a patient with shortness of breath and coughing. The ED physician performs a level-three E/M, then orders a spirometry. Based on test results, the physician diagnoses chronic obstructive pulmonary disease (COPD) with acute bronchitis. I reported 94010 and 99283, and the insurer rejected the spirometry code. What did I do wrong? Connecticut SubscriberAnswer: A spirometry is not separately billable by the ED physician. You cannot report 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation) for this encounter. In the future, see if...

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