How To Use CPT Code 94453

CPT 94453 describes the high altitude simulation test (HAST) with supplemental oxygen titration, which is performed by a physician or other qualified healthcare professional. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 94453?

CPT 94453 is used to report the high altitude simulation test (HAST) with supplemental oxygen titration. This test is performed by a physician or other qualified healthcare professional to assess the patient’s oxyhemoglobin saturations while breathing a low oxygen mixture. The provider adjusts the supplemental oxygen to maintain the patient’s saturation at appropriate levels. The results of the test are interpreted by the provider, and a report is created.

2. Official Description

The official description of CPT code 94453 is: ‘High altitude simulation test (HAST), with interpretation and report by a physician or other qualified healthcare professional; with supplemental oxygen titration.’

3. Procedure

1. The provider places an airtight mask over the patient’s face.
2. The patient breathes a low oxygen mixture for approximately 15 minutes.
3. The provider monitors the patient’s oxyhemoglobin saturation.
4. If the saturation drops below 88 percent, the provider supplies supplemental oxygen using a nasal tube.
5. The provider adjusts the flow rate of the supplemental oxygen until the patient’s saturation rises above 88 percent.
6. The provider analyzes the results, including flow rate details, and creates a report.

4. Qualifying circumstances

CPT 94453 is used for patients undergoing a high altitude simulation test (HAST) with supplemental oxygen titration. This test is typically performed on patients suspected of having high altitude-related conditions. The test must be interpreted and reported by a physician or other qualified healthcare professional.

5. When to use CPT code 94453

CPT code 94453 should be used when a high altitude simulation test (HAST) is performed with supplemental oxygen titration. This code should not be reported in conjunction with codes 94452, 94760, or 94761.

6. Documentation requirements

To support a claim for CPT 94453, the provider must document the following information:

• Patient’s medical history and reason for performing the high altitude simulation test
• Details of the test, including the duration of the low oxygen mixture and the flow rate of supplemental oxygen
• Oxyhemoglobin saturation levels throughout the test
• Any adjustments made to the supplemental oxygen flow rate
• Interpretation of the test results
• Creation of a report by the interpreting provider

7. Billing guidelines

When billing for CPT 94453, ensure that the test is performed by a physician or other qualified healthcare professional. If only the professional interpretation is being reported, append modifier 26 to the code. If only the technical component is being reported, append modifier TC. Do not append any modifiers when reporting a global service in which one provider performs both the professional and technical components. Do not report CPT 94453 in conjunction with codes 94452, 94760, or 94761.

8. Historical information

CPT 94453 was added to the Current Procedural Terminology system on January 1, 2005. On January 1, 2013, the code description was changed to include ‘with physician interpretation and report.’

9. Examples

1. A physician performing a high altitude simulation test (HAST) with supplemental oxygen titration for a patient with suspected high altitude-related illness.
2. A qualified healthcare professional conducting a HAST with supplemental oxygen titration to assess a patient’s response to low oxygen levels.
3. A provider performing a HAST with supplemental oxygen titration for a patient with symptoms of altitude sickness.
4. A physician administering a HAST with supplemental oxygen titration to evaluate a patient’s ability to tolerate high altitude environments.
5. A qualified healthcare professional conducting a HAST with supplemental oxygen titration for a patient preparing for a high altitude expedition.
6. A provider performing a HAST with supplemental oxygen titration to assess a patient’s oxygen saturation levels at high altitudes.
7. A physician administering a HAST with supplemental oxygen titration to evaluate a patient’s response to low oxygen levels during simulated high altitude conditions.
8. A qualified healthcare professional conducting a HAST with supplemental oxygen titration for a patient with a history of altitude-related health issues.
9. A provider performing a HAST with supplemental oxygen titration to assess a patient’s ability to acclimatize to high altitude environments.
10. A physician administering a HAST with supplemental oxygen titration to evaluate a patient’s oxygen saturation levels during simulated high altitude conditions.