How To Use CPT Code 94450

CPT 94450 describes the pulmonary function test that measures the lungs’ response to an inadequate supply of oxygen. 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 94450?

CPT 94450 can be used to describe a pulmonary function test that assesses how the lungs respond to a lack of oxygen. This test helps healthcare providers evaluate a patient’s lung function and determine any abnormalities or issues related to oxygen supply. It involves measuring the lung volume and assessing the ventilatory response to hypoxia.

2. Official Description

The official description of CPT code 94450 is: ‘Breathing response to hypoxia (hypoxia response curve).’ This code specifically focuses on evaluating the lungs’ reaction to a reduced oxygen supply and the subsequent changes in breathing patterns.

3. Procedure

1. During the pulmonary function test, the healthcare provider measures the patient’s lung function using various techniques, such as an open-circuit nitrogen washout or a closed-circuit helium dilution technique.
2. The patient is asked to breathe in nitrogen or helium gas through a tube for a specific duration.
3. The provider then measures the change in gas concentration in a chamber attached to the tube after the patient completes the breathing process.
4. Using the initial gas concentration, the spirometer volume, and other calculations, the provider determines the gas amount in the patient’s lungs at the beginning of the test, along with functional residual capacity and residual volume.
5. Throughout the test, the provider decreases the patient’s oxygen saturation and monitors the ventilatory response to hypoxia using techniques like rebreathing, end-tidal forcing, or pulse oximeter readings.

4. Qualifying circumstances

CPT 94450 is applicable when a patient undergoes a pulmonary function test to assess their breathing response to hypoxia. This test is typically performed on individuals with suspected lung disorders or those who require evaluation of their lung function due to symptoms like shortness of breath or decreased oxygen levels. The test is conducted by a healthcare provider experienced in performing and interpreting pulmonary function tests.

5. When to use CPT code 94450

CPT code 94450 should be used when a patient undergoes a pulmonary function test specifically focused on evaluating their breathing response to hypoxia. This code is appropriate when the test measures the lungs’ reaction to a reduced oxygen supply and assesses the changes in breathing patterns. It is important to ensure that the test performed aligns with the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 94450, the healthcare provider must document the following information:

• Reason for performing the pulmonary function test and the need to assess the breathing response to hypoxia
• Details of the specific techniques used during the test, such as open-circuit nitrogen washout or closed-circuit helium dilution
• Date and duration of the test
• Results of the test, including measurements of lung volume and ventilatory response to hypoxia
• Any abnormalities or significant findings observed during the test
• Signature of the healthcare provider performing the test

7. Billing guidelines

When billing for CPT 94450, it is important to ensure that the test performed aligns with the specific criteria outlined in the code description. 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. Do not append a professional or technical modifier when reporting a global service where one provider renders both components. It is also important to consider any additional guidelines or requirements from the payer when submitting the claim.

8. Historical information

CPT 94450 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with suspected lung disease undergoes a pulmonary function test to assess their breathing response to hypoxia.
2. A healthcare provider performs a breathing response test on a patient with chronic obstructive pulmonary disease (COPD) to evaluate their lung function.
3. A patient with symptoms of shortness of breath undergoes a pulmonary function test to determine their breathing response to hypoxia.
4. A healthcare provider conducts a breathing response test on a patient with a history of lung cancer to assess their lung function.
5. A patient with suspected respiratory disorders undergoes a pulmonary function test to evaluate their breathing response to hypoxia.
6. A healthcare provider performs a breathing response test on a patient with asthma to assess their lung function and breathing patterns.
7. A patient with symptoms of decreased oxygen levels undergoes a pulmonary function test to determine their breathing response to hypoxia.
8. A healthcare provider conducts a breathing response test on a patient with interstitial lung disease to evaluate their lung function and breathing patterns.
9. A patient with suspected pulmonary fibrosis undergoes a pulmonary function test to assess their breathing response to hypoxia.
10. A healthcare provider performs a breathing response test on a patient with a history of smoking to evaluate their lung function and assess any potential lung damage.