How To Use CPT Code 94013

CPT 94013 describes the measurement of lung volumes in infants and children up to two years old. 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 94013?

CPT 94013 can be used to measure the lung volumes in infants and children up to two years old. This code is used when a healthcare provider performs a pulmonary function test to determine the amount of air in the lungs at different points during breathing. The test helps in assessing various lung conditions in young patients.

2. Official Description

The official description of CPT code 94013 is: ‘Measurement of lung volumes (i.e., functional residual capacity [FRC], forced vital capacity [FVC], and expiratory reserve volume [ERV]) in an infant or child through 2 years of age.’

3. Procedure

  1. The healthcare provider prepares and anesthetizes the infant or child for the procedure.
  2. The provider uses a technique called raised volume rapid thoracoabdominal compression (RVRTC) to obtain lung volume measurements.
  3. A pneumatic jacket-like device is placed on the patient, and a series of measurements are taken before, during, and after the device mechanically squeezes the patient’s chest.
  4. The measurements include functional residual capacity (FRC), forced vital capacity (FVC), and expiratory reserve volume (ERV).
  5. Various techniques, such as gas dilution methods or plethysmography, may be used to measure the lung volumes at the central airways.

4. Qualifying circumstances

CPT 94013 is performed on infants and children up to two years old who require measurement of lung volumes. This procedure is used to assess lung conditions and is typically performed when other diagnostic tests are inconclusive. The healthcare provider must use the appropriate technique, such as RVRTC or plethysmography, to obtain accurate measurements of functional residual capacity (FRC), forced vital capacity (FVC), and expiratory reserve volume (ERV).

5. When to use CPT code 94013

CPT code 94013 should be used when a healthcare provider needs to measure the lung volumes in infants and children up to two years old. This code is appropriate when other diagnostic tests are inconclusive and when the provider uses the specific techniques mentioned in the official description. It is important to ensure that the patient falls within the age range specified in the code description.

6. Documentation requirements

To support a claim for CPT 94013, the healthcare provider must document the following information:

  • Age of the patient (up to two years old)
  • Reason for performing the lung volume measurement
  • Specific technique used (e.g., RVRTC or plethysmography)
  • Date and time of the procedure
  • Results of the measurements, including functional residual capacity (FRC), forced vital capacity (FVC), and expiratory reserve volume (ERV)
  • Any additional relevant information or observations
  • Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 94013, ensure that the procedure is performed on an infant or child up to two years old. Use the appropriate technique, such as RVRTC or plethysmography, as specified in the code description. It is important to follow any additional guidelines provided by the payer or coding guidelines. Consider reporting CPT 94013 with other relevant codes, such as those for spirometric forced expiratory flows, if applicable.

8. Historical information

CPT 94013 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 performs a lung volume measurement using RVRTC on a one-year-old infant to assess their respiratory function.
  2. An anesthesiologist measures the functional residual capacity (FRC), forced vital capacity (FVC), and expiratory reserve volume (ERV) in a two-year-old child using plethysmography.
  3. A pulmonologist performs a pulmonary function test on a six-month-old baby to evaluate their lung volumes and diagnose any potential respiratory conditions.
  4. A pediatrician uses RVRTC to measure the lung volumes in a one-year-old child with suspected lung abnormalities.
  5. A respiratory therapist performs a lung volume measurement on a two-year-old toddler using gas dilution methods to assess their respiratory health.
  6. An allergist measures the functional residual capacity (FRC), forced vital capacity (FVC), and expiratory reserve volume (ERV) in a nine-month-old infant to evaluate their lung function and diagnose any potential allergies or asthma.
  7. A neonatologist performs a lung volume measurement on a premature newborn using plethysmography to assess their respiratory development.
  8. A pediatric pulmonologist measures the lung volumes in a one-year-old child with a history of recurrent respiratory infections to evaluate their lung function and determine appropriate treatment.
  9. An otolaryngologist performs a lung volume measurement on a two-year-old child with suspected airway obstruction to assess their respiratory function.
  10. A pediatric cardiologist measures the functional residual capacity (FRC), forced vital capacity (FVC), and expiratory reserve volume (ERV) in a one-year-old child with a congenital heart defect to evaluate their respiratory status.

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