How To Use CPT Code 94728

CPT 94728 describes the measurement of airway resistance using sound waves. 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 94728?

CPT 94728 is used to measure airway resistance by utilizing sound waves. This code is specifically used to check the resistance in the airways of the lungs. It is commonly performed for patients with lung-related conditions such as asthma and chronic obstructive pulmonary disease (COPD).

2. Official Description

The official description of CPT code 94728 is: ‘Airway resistance by oscillometry.’

3. Procedure

1. The testing provider sets up the instruments required for the pulmonary function testing (PFT).
2. The patient breathes normally through a pneumotachograph, which records the airflow to and from the lungs.
3. Sound waves are overlaid on the patient’s breathing to calculate the airway resistance.
4. The provider may administer bronchodilators, which help open the airways, during the test.
5. The provider performing the interpretation reviews the data from the test, checks for errors, and interprets the results.
6. The results are then recorded in the patient’s medical record.

4. Qualifying circumstances

CPT 94728 is typically performed for patients with lung-related conditions such as asthma and COPD. It is used to assess airway resistance and determine the effectiveness of treatment. The test is performed by a qualified healthcare professional who is trained in conducting and interpreting pulmonary function tests.

5. When to use CPT code 94728

CPT code 94728 should be used when measuring airway resistance using sound waves. It is appropriate for patients with lung-related conditions who require assessment of their airway function. This code should not be reported in conjunction with other specific codes related to pulmonary function testing.

6. Documentation requirements

To support a claim for CPT 94728, the healthcare professional must document the following information:

• Patient’s diagnosis and the reason for performing the airway resistance test
• Details of the testing instruments used
• Date and time of the test
• Administration of bronchodilators, if applicable
• Interpretation of the test results
• Signature of the healthcare professional performing the test and interpreting the results

7. Billing guidelines

When billing for CPT 94728, ensure that the test is performed by a qualified healthcare professional. If only the professional component is being reported, append modifier 26 to the code. If only the technical component is being reported, append modifier TC to the code. However, if the technical component is provided by a hospital, do not append modifier TC. It is important to follow the appropriate guidelines for reporting the professional and technical components of the service.

8. Historical information

CPT 94728 was added to the Current Procedural Terminology system on January 1, 2012. The code was previously known as ‘Airway resistance by impulse oscillometry’ before the name change on January 1, 2020.

9. Examples

1. A patient with asthma undergoes airway resistance testing using sound waves to assess the effectiveness of their current treatment plan.
2. A patient with COPD undergoes airway resistance testing to monitor their lung function and adjust their medication regimen accordingly.
3. A healthcare professional performs airway resistance testing on a patient with suspected airway obstruction to aid in diagnosis and treatment planning.
4. A patient with a history of lung-related symptoms undergoes airway resistance testing to evaluate their respiratory health and guide further management.
5. A healthcare professional performs airway resistance testing on a patient before and after administering bronchodilators to assess their response to the medication.
6. A patient with a chronic lung condition undergoes regular airway resistance testing to monitor their disease progression and adjust their treatment plan as needed.
7. A healthcare professional performs airway resistance testing on a patient with suspected exercise-induced bronchoconstriction to confirm the diagnosis and guide treatment recommendations.
8. A patient with a history of smoking undergoes airway resistance testing to assess their lung function and screen for any potential respiratory abnormalities.
9. A healthcare professional performs airway resistance testing on a patient with a known respiratory allergy to evaluate the impact of allergen exposure on their airway function.
10. A patient with a history of occupational exposure to respiratory irritants undergoes airway resistance testing to assess the potential impact on their lung health.