How To Use CPT Code 94011

CPT 94011 describes the measurement of spirometric forced expiratory flows in an infant or child through 2 years of age. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 94011?

CPT 94011 can be used to measure the forced expiratory flow of air in an infant or child up to 2 years old. This test assesses airway function, determines lung dysfunction and disease, and evaluates the effects of therapeutic interventions. It is performed by a healthcare provider using a spirometer, which measures the amount and rate of air taken into and exhaled out of the lungs over a period of time.

2. Official Description

The official description of CPT code 94011 is: ‘Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age.’

3. Procedure

1. The healthcare provider prepares the patient, ensuring they are appropriately prepped and anesthetized.
2. A mask is placed tightly over the patient’s nose and mouth.
3. The patient is positioned in an inflatable jacket-type device that covers their chest and abdomen.
4. The provider attaches measuring equipment to the mask and applies pressure in sync with the patient’s inhalation.
5. The provider gently squeezes the patient’s chest to produce a forced expiration of air, while the jacket is inflated to a predetermined pressure.
6. The provider repeats the process, repositioning the patient and facemask as needed, while taking a series of forced expiratory flow and lung volume measurements.
7. The provider evaluates the data and documents the results.

4. Qualifying circumstances

CPT 94011 is performed on infants and children up to 2 years old to assess their lung function. It is used to measure forced expiratory flows and can help determine if there is any airway dysfunction or disease present. This test is typically performed by a healthcare provider who is trained in using a spirometer and interpreting the results.

5. When to use CPT code 94011

CPT code 94011 should be used when measuring spirometric forced expiratory flows in an infant or child up to 2 years old. It is appropriate when assessing airway function, determining lung dysfunction and disease, and evaluating the effects of therapeutic interventions. This code should not be used for patients older than 2 years of age or for other types of pulmonary function tests.

6. Documentation requirements

To support a claim for CPT 94011, the healthcare provider must document the following information:

• Patient’s age and indication for the test
• Details of the procedure, including the use of a spirometer and the specific measurements taken
• Date and time of the test
• Results of the test, including any abnormalities or significant findings
• Signature of the healthcare provider performing the test

7. Billing guidelines

When billing for CPT 94011, ensure that the test is performed on an infant or child up to 2 years old. Use the appropriate CPT code based on the specific procedure performed. It is important to accurately document the details of the test and any relevant findings to support the billing claim. CPT code 94011 should not be reported with other codes unless there are additional services provided that are separately billable.

8. Historical information

CPT 94011 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider measures the forced expiratory flow of air in a 1-year-old child to assess their lung function.
2. An infant undergoes spirometric testing to evaluate their airway function and determine if there are any signs of lung dysfunction.
3. A 2-year-old child with a history of respiratory issues undergoes spirometry to monitor the effects of their current therapeutic interventions.
4. A healthcare provider measures the forced expiratory flow of air in a newborn to assess their lung development and function.
5. An infant with suspected airway obstruction undergoes spirometry to determine the severity of the obstruction and guide treatment decisions.
6. A child with a chronic lung disease undergoes spirometry to monitor their lung function over time and assess the effectiveness of their treatment plan.
7. A healthcare provider measures the forced expiratory flow of air in a 6-month-old infant to evaluate their respiratory health and identify any potential issues.
8. An infant with a congenital heart defect undergoes spirometry to assess their lung function and determine if there are any associated respiratory complications.
9. A child with a history of prematurity undergoes spirometry to evaluate their lung development and assess for any signs of respiratory distress.
10. A healthcare provider measures the forced expiratory flow of air in a 2-year-old child with asthma to monitor their lung function and adjust their treatment plan accordingly.