How To Use CPT Code 94012

CPT 94012 describes the measurement of spirometric forced expiratory flows, before and after bronchodilator, 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 94012?

CPT 94012 can be used to measure the forced expiratory flow of air in the lungs of an infant or child up to 2 years old. This test is performed to assess airway function, determine lung dysfunction and disease, and evaluate the effects of therapeutic interventions. It involves measuring the amount and rate of air taken into the lungs and exhaled out of the lungs over a period of time using a spirometer.

2. Official Description

The official description of CPT code 94012 is: ‘Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age.’

3. Procedure

1. The provider prepares the patient by 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 the chest and abdomen.
4. Measuring equipment is attached to the mask.
5. The provider applies pressure in sync with the patient’s inhalation using an automatic device.
6. The provider gently squeezes the chest to produce a forced expiration of air, which may create a momentary respiratory pause to ensure accurate measurements.
7. A series of forced expiratory flow and lung volume measurements are taken.
8. A bronchodilator is administered to relax and widen the air passages of the lungs.
9. The procedure is repeated using the same technique and settings as before bronchodilation.
10. The provider evaluates the data to ensure accuracy of the documented results.

4. Qualifying circumstances

CPT 94012 is performed on infants and children up to 2 years old to assess their lung function. It is typically used to evaluate airway function, determine lung dysfunction and disease, and assess the effects of therapeutic interventions. The procedure should be performed by a qualified healthcare professional who is experienced in conducting pulmonary function tests and interpreting the results.

5. When to use CPT code 94012

CPT code 94012 should be used when measuring spirometric forced expiratory flows in an infant or child up to 2 years old, both before and after the administration of a bronchodilator. This code is specific to this age group and procedure and should not be used for other patient populations or different types of pulmonary function tests.

6. Documentation requirements

To support a claim for CPT 94012, the healthcare professional must document the following information:

• Patient’s age and indication for the test
• Details of the procedure, including the use of a bronchodilator
• Date and time of the test
• Results of the forced expiratory flow measurements before and after bronchodilation
• Any additional relevant information or observations
• Signature of the healthcare professional performing the test

7. Billing guidelines

When billing for CPT 94012, ensure that the procedure is performed on an infant or child up to 2 years old. It is important to accurately document the use of a bronchodilator and the results of the forced expiratory flow measurements. CPT code 94012 should not be reported with other codes unless there are additional services provided that are separately billable. It is recommended to review payer-specific guidelines for any additional requirements or modifiers that may be necessary for proper reimbursement.

8. Historical information

CPT 94012 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. An infant undergoing spirometric forced expiratory flow measurement before and after bronchodilation to assess airway function.
2. A 1-year-old child with suspected lung dysfunction receiving spirometric forced expiratory flow measurement before and after bronchodilation to evaluate the effects of therapeutic interventions.
3. A 2-year-old child with a history of respiratory disease undergoing spirometric forced expiratory flow measurement before and after bronchodilation to determine lung dysfunction and disease.
4. An infant with suspected asthma receiving spirometric forced expiratory flow measurement before and after bronchodilation to assess airway function and evaluate the effects of a bronchodilator.
5. A 6-month-old child with recurrent respiratory infections undergoing spirometric forced expiratory flow measurement before and after bronchodilation to assess lung function and determine the need for further interventions.
6. A 2-year-old child with a congenital heart defect receiving spirometric forced expiratory flow measurement before and after bronchodilation to evaluate the effects of therapeutic interventions on lung function.
7. An infant with suspected cystic fibrosis undergoing spirometric forced expiratory flow measurement before and after bronchodilation to assess airway function and determine the presence of lung dysfunction.
8. A 1-year-old child with a history of prematurity receiving spirometric forced expiratory flow measurement before and after bronchodilation to evaluate the effects of therapeutic interventions on lung function.
9. An infant with suspected bronchopulmonary dysplasia undergoing spirometric forced expiratory flow measurement before and after bronchodilation to assess lung function and determine the need for additional interventions.