How To Use CPT Code 94680

CPT 94680 describes the measurement of a patient’s oxygen uptake through the analysis of expired gas during rest and exercise. 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 94680?

CPT 94680 can be used to describe the measurement of a patient’s oxygen uptake by analyzing the gas they exhale during both rest and exercise. This code is used when a provider collects the patient’s expelled air and uses it to determine their oxygen consumption rate.

2. Official Description

The official description of CPT code 94680 is: ‘Oxygen uptake, expired gas analysis; rest and exercise, direct, simple.’

3. Procedure

1. The provider prepares the testing system for collecting the patient’s exhaled breath.
2. The patient breathes in through a special device that allows for air to come in but collects all expelled air in a device such as a Douglas bag.
3. The provider performs expired air collection both with the patient at rest and during exercise, such as a set time on an exercise bike or treadmill.
4. The provider uses a gas analyzer to measure the patient’s oxygen consumption rate based on the collected expired air.

4. Qualifying circumstances

Patients eligible for CPT 94680 are those who require the measurement of their oxygen uptake through expired gas analysis during rest and exercise. This procedure is typically performed on patients with respiratory or cardiovascular conditions. The provider must collect the patient’s exhaled air and use a gas analyzer to measure their oxygen consumption rate.

5. When to use CPT code 94680

CPT code 94680 should be used when a provider needs to measure a patient’s oxygen uptake through expired gas analysis during both rest and exercise. It is important to note that this code should not be reported with other codes for the same service.

6. Documentation requirements

To support a claim for CPT 94680, the provider must document the following information:

• Patient’s condition and the need for oxygen uptake measurement
• Date and time of the procedure
• Details of the testing system used
• Results of the gas analysis, including the patient’s oxygen consumption rate
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 94680, ensure that the procedure is performed by a qualified provider and that the patient’s oxygen uptake is measured during both rest and exercise. It is important to follow the guidelines for reporting the professional and technical components of the service. Modifier 26 should be appended to the code when reporting only the professional interpretation, while modifier TC indicates reporting only the technical component. Do not append any modifiers when reporting a global service where one provider renders both components.

8. Historical information

CPT 94680 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient with chronic obstructive pulmonary disease (COPD) undergoing oxygen uptake measurement during rest and exercise to assess their respiratory function.
2. A patient with heart failure undergoing expired gas analysis to evaluate their oxygen consumption rate during rest and exercise.
3. A patient with asthma undergoing oxygen uptake measurement to monitor their respiratory function during rest and exercise.
4. A patient with pulmonary fibrosis undergoing expired gas analysis to assess their oxygen consumption rate and lung function during rest and exercise.
5. A patient with cardiovascular disease undergoing oxygen uptake measurement to evaluate their exercise capacity and cardiovascular health.
6. A patient with cystic fibrosis undergoing expired gas analysis to monitor their oxygen consumption rate and respiratory function during rest and exercise.
7. A patient with pulmonary hypertension undergoing oxygen uptake measurement to assess their exercise tolerance and pulmonary function.
8. A patient with bronchitis undergoing expired gas analysis to evaluate their oxygen consumption rate and respiratory function during rest and exercise.
9. A patient with interstitial lung disease undergoing oxygen uptake measurement to assess their exercise capacity and lung function.
10. A patient with sleep apnea undergoing expired gas analysis to monitor their oxygen consumption rate and respiratory function during rest and exercise.