How To Use CPT Code 94060

CPT 94060 is a code used for bronchodilation responsiveness testing, involving spirometry before and after bronchodilator administration. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 94060.

1. What is CPT 94060?

CPT 94060 is a medical billing code used to describe a specific type of pulmonary function test called bronchodilation responsiveness testing. This test involves performing spirometry, a lung function test, before and after the administration of a bronchodilator medication. The purpose of this test is to evaluate the responsiveness of a patient’s respiratory system to the bronchodilator and to assess lung function over time.

2. 94060 CPT code description

The official description of CPT code 94060 is: “Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration.”

3. Procedure

The procedure for CPT 94060 involves the following steps:

1. The patient is asked to take a deep breath and exhale forcefully into the mouthpiece of a spirometer, which measures the speed and volume of air flow.
2. The spirometer records the initial results and plots them on a graph, known as a spirogram.
3. A bronchodilator medication is administered to the patient, either in aerosol or parenteral form.
4. After a specified waiting period, the patient repeats the spirometry test.
5. The post-bronchodilator results are recorded and compared to the pre-bronchodilator results to assess the patient’s responsiveness to the medication.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 94060 services are those who have been diagnosed with or are suspected of having a respiratory condition that may respond to bronchodilator therapy. This may include conditions such as asthma, chronic obstructive pulmonary disease (COPD), or other respiratory disorders. The test may also be used to monitor the effectiveness of bronchodilator medications in patients who are already receiving treatment for these conditions.

5. When to use CPT code 94060

It is appropriate to bill the 94060 CPT code when a healthcare provider performs a bronchodilation responsiveness test to evaluate a patient’s lung function and responsiveness to bronchodilator therapy. This test may be performed as part of the diagnostic process for respiratory conditions or to monitor the effectiveness of treatment in patients with established diagnoses.

6. Documentation requirements

To support a claim for CPT 94060, the following information should be documented:

• Patient’s medical history and presenting symptoms
• Physical examination findings related to the respiratory system
• Indication for the bronchodilation responsiveness test
• Details of the spirometry procedure, including pre- and post-bronchodilator results
• Interpretation of the test results and their clinical significance
• Any recommendations for further testing or treatment based on the test results

7. Billing guidelines

When billing for CPT code 94060, it is important to follow the appropriate guidelines and rules. Some tips for billing this code include:

• Do not report CPT 94060 in conjunction with codes 94150, 94200, 94375, 94640, or 94728.
• Report the supply of the bronchodilator separately using code 99070 or the appropriate supply code.
• For exercise tests for bronchospasm with pre- and post-spirometry, use codes 94617 or 94619 instead of 94060.

8. Historical information

CPT 94060 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2005, with the previous descriptor being “Bronchospasm evaluation: spirometry as in 94010, before and after bronchodilator (aerosol or parenteral).”

9. Similar codes to CPT 94060

Five similar codes to CPT 94060 and how they differ are:

• CPT 94010: This code is for basic spirometry testing without bronchodilator administration.
• CPT 94617: This code is for exercise-induced bronchospasm testing with pre- and post-spirometry, but without bronchodilator administration.
• CPT 94619: This code is for exercise-induced bronchospasm testing with pre- and post-spirometry, including bronchodilator administration.
• CPT 94375: This code is for respiratory flow volume loop studies, which are different from spirometry tests.
• CPT 94728: This code is for lung volume measurements using gas dilution or washout techniques, which are not part of the bronchodilation responsiveness test.

10. Examples

Here are 10 detailed examples of CPT code 94060 procedures:

1. A patient with a history of asthma presents with increased shortness of breath and wheezing. The healthcare provider performs a bronchodilation responsiveness test to assess the patient’s lung function and responsiveness to bronchodilator therapy.
2. A patient with COPD experiences a decline in lung function despite ongoing treatment. The healthcare provider performs a bronchodilation responsiveness test to evaluate the effectiveness of the patient’s current bronchodilator medication.
3. A patient with a suspected respiratory disorder undergoes a bronchodilation responsiveness test as part of the diagnostic process to determine the presence of reversible airway obstruction.
4. A patient with a history of smoking presents with chronic cough and shortness of breath. The healthcare provider performs a bronchodilation responsiveness test to assess the patient’s lung function and determine if bronchodilator therapy is indicated.
5. A patient with a known respiratory condition undergoes a bronchodilation responsiveness test to monitor the effectiveness of their current bronchodilator medication and determine if any adjustments to their treatment plan are necessary.
6. A patient with a history of occupational exposure to respiratory irritants presents with shortness of breath and wheezing. The healthcare provider performs a bronchodilation responsiveness test to evaluate the patient’s lung function and responsiveness to bronchodilator therapy.
7. A patient with a family history of respiratory disorders undergoes a bronchodilation responsiveness test as part of a comprehensive pulmonary evaluation to assess their lung function and determine if they have any underlying respiratory issues.
8. A patient with a history of recurrent respiratory infections presents with persistent shortness of breath and wheezing. The healthcare provider performs a bronchodilation responsiveness test to assess the patient’s lung function and responsiveness to bronchodilator therapy.
9. A patient with a history of allergic rhinitis and asthma undergoes a bronchodilation responsiveness test to evaluate the effectiveness of their current bronchodilator medication and determine if any adjustments to their treatment plan are necessary.
10. A patient with a history of exercise-induced bronchospasm undergoes a bronchodilation responsiveness test to assess their lung function and responsiveness to bronchodilator therapy during periods of increased physical activity.