How To Use CPT Code 94070

CPT 94070 describes the bronchospasm provocation evaluation, a diagnostic test used to measure airway hypersensitivity in patients without clinically apparent asthma. 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 94070?

CPT 94070 is a diagnostic test that measures airway hypersensitivity in patients who do not present with clinically apparent asthma. The test involves deliberately inducing bronchospasm by controlled exposure to a specific stimulant, such as cold air or methacholine. Multiple spirometric determinations are then performed to evaluate lung function under the compromised condition of the bronchial airways.

2. Official Description

The official description of CPT code 94070 is: ‘Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine).’ It is important to note that CPT code 94070 should not be reported in conjunction with CPT code 94640. Additionally, if antigen administration is performed, it should be reported separately with CPT code 99070 or the appropriate supply code.

3. Procedure

In the bronchospasm provocation evaluation, the healthcare provider deliberately induces bronchospasm by controlled and measurable exposure to a specific stimulant, such as cold air or methacholine. The provider then performs spirometry multiple times to evaluate lung function under the induced bronchospasm. This procedure helps detect airway hypersensitivity in patients without clinically apparent asthma.

4. Qualifying circumstances

CPT 94070 is typically performed on patients who do not present with clinically apparent asthma but may have airway hypersensitivity. The test is used to evaluate the functionality of the bronchial airways under compromised conditions. It is important to note that CPT code 94070 should not be reported in conjunction with CPT code 94640.

5. When to use CPT code 94070

CPT code 94070 should be used when a healthcare provider needs to evaluate airway hypersensitivity in patients without clinically apparent asthma. It is appropriate to use this code when performing the bronchospasm provocation evaluation, which involves inducing bronchospasm and conducting multiple spirometric determinations to assess lung function under compromised conditions.

6. Documentation requirements

To support a claim for CPT 94070, the healthcare provider must document the following information:

• Patient’s symptoms or indications for performing the bronchospasm provocation evaluation
• The specific stimulant used to induce bronchospasm (eg, cold air, methacholine)
• Date and time of the procedure
• Results of the spirometric determinations
• Any additional relevant information or observations

7. Billing guidelines

When billing for CPT 94070, it is important to append the appropriate modifiers based on the professional and technical components of the service. If reporting only the professional component, append modifier 26 to the code. If reporting only the technical component, append modifier TC to the code, unless the hospital provided the technical component. In that case, do not append modifier TC. It is also important to note that CPT code 94070 should not be reported in conjunction with CPT code 94640.

8. Historical information

CPT 94070 was added to the Current Procedural Terminology system on January 1, 1990. Since then, there have been a few historical changes to the code. On January 1, 2005, the code description was changed to ‘Prolonged postexposure evaluation of bronchospasm with multiple spirometric determinations after antigen, cold air, methacholine, or other chemical agent, with subsequent spirometrics.’ On January 1, 2008, the code description was changed to its current form: ‘Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine).’ No further updates have been made to the code since then.

9. Similar codes to CPT 94070

Five similar codes to CPT 94070 include:

• CPT 94010: This code is used for simple spirometry, a diagnostic test that measures the flow and volume of air during inhalation and exhalation.
• CPT 94060: This code is used for bronchial challenge testing, which involves the administration of a specific stimulant to assess airway responsiveness.
• CPT 94071: This code is used for bronchospasm provocation evaluation with pre- and post-bronchodilator spirometry, which includes the administration of a bronchodilator before and after the bronchospasm provocation.
• CPT 94072: This code is used for bronchospasm provocation evaluation with pre- and post-bronchodilator spirometry and multiple spirometric determinations, which includes the administration of a bronchodilator before and after the bronchospasm provocation, as well as multiple spirometric determinations.
• CPT 94073: This code is used for bronchospasm provocation evaluation with pre- and post-bronchodilator spirometry and multiple spirometric determinations, including pre- and post-bronchodilator spirometry, as well as multiple spirometric determinations.

9. Examples

1. A pulmonologist performing a bronchospasm provocation evaluation on a patient with suspected airway hypersensitivity.
2. A respiratory therapist conducting a bronchospasm provocation evaluation on a patient without clinically apparent asthma to assess their airway responsiveness.
3. A allergist administering a specific stimulant and performing multiple spirometric determinations to evaluate airway hypersensitivity in a patient with suspected bronchial hyperreactivity.
4. A pulmonologist inducing bronchospasm and conducting spirometry multiple times to assess lung function under compromised conditions in a patient with unexplained respiratory symptoms.
5. A respiratory therapist performing a bronchospasm provocation evaluation on a patient with suspected airway hypersensitivity to determine the appropriate treatment plan.