How To Use CPT Code 94681

CPT 94681 describes the measurement of oxygen uptake and carbon dioxide production in a patient’s expired air during rest and exercise. 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 94681?

CPT 94681 is used to measure the rate of oxygen uptake and carbon dioxide production in a patient’s expired air during rest and exercise. This procedure involves collecting the patient’s expelled air and analyzing it using a gas analyzer. It helps assess the patient’s fitness level during specific activities.

2. Official Description

The official description of CPT code 94681 is: ‘Oxygen uptake, expired gas analysis; including CO2 output, percentage oxygen extracted.’

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 air to come in but collects all expelled air in a device such as a Douglas bag.
3. The provider collects expired air from the patient both at rest and during exercise, such as on an exercise bike or treadmill.
4. A gas analyzer is used to measure the patient’s rate of oxygen uptake and carbon dioxide production based on the collected expired air.
5. This test helps evaluate the patient’s fitness level during a specific activity.

4. Qualifying circumstances

CPT 94681 is typically performed on patients who require an assessment of their oxygen uptake and carbon dioxide production during rest and exercise. It is commonly used in evaluating the fitness level of athletes or individuals with respiratory or cardiovascular conditions. The procedure should be performed by a qualified healthcare professional who is trained in administering and interpreting the test results.

5. When to use CPT code 94681

CPT code 94681 should be used when there is a need to measure a patient’s oxygen uptake and carbon dioxide production during rest and exercise. It is appropriate for assessing the fitness level of individuals participating in physical activities or for evaluating the impact of respiratory or cardiovascular conditions on their exercise capacity.

6. Documentation requirements

To support a claim for CPT code 94681, the healthcare professional must document the following information:

• Patient’s demographic information
• Date and time of the procedure
• Details of the testing system used
• Results of the oxygen uptake and carbon dioxide production measurements
• Interpretation of the test results
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 94681, it is important to follow the appropriate guidelines. If only the professional component is being reported, modifier 26 should be appended to the code. If only the technical component is being reported, modifier TC should be appended to the code. However, if the technical component is provided by a hospital, modifier TC should not be appended. It is also important to consider the global service rules when reporting this code.

8. Historical information

CPT code 94681 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 professional athlete undergoing CPT code 94681 to assess their oxygen uptake and carbon dioxide production during exercise.
2. A patient with chronic obstructive pulmonary disease (COPD) undergoing CPT code 94681 to evaluate their exercise capacity.
3. An individual participating in a research study on the effects of a new medication on oxygen uptake and carbon dioxide production during rest and exercise, requiring CPT code 94681.
4. A patient with a suspected respiratory condition undergoing CPT code 94681 to determine their fitness level and exercise capacity.
5. An individual undergoing CPT code 94681 as part of a pre-employment physical to assess their ability to perform physically demanding tasks.
6. A patient with a cardiovascular condition undergoing CPT code 94681 to evaluate their exercise tolerance and cardiovascular fitness.
7. An athlete undergoing CPT code 94681 as part of their regular fitness assessment to track their progress and optimize their training regimen.
8. A patient with a history of asthma undergoing CPT code 94681 to assess their exercise-induced bronchoconstriction and determine appropriate treatment strategies.
9. An individual participating in a weight loss program undergoing CPT code 94681 to monitor their progress and evaluate the impact of exercise on their metabolic rate.
10. A patient with a suspected metabolic disorder undergoing CPT code 94681 to measure their oxygen uptake and carbon dioxide production during rest and exercise.