How To Use CPT Code 95070

CPT 95070 describes the bronchial challenge test, also known as a histamine challenge test or a methacholine challenge test, which is used to assist in the diagnosis of asthma. 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 95070?

CPT 95070 can be used to describe the bronchial challenge test, a diagnostic procedure used to assess airway responsiveness in patients with asthma. This test involves the patient inhaling a substance such as histamine, methacholine, or similar compounds to detect how the airways respond. The provider records any allergic reactions and changes in inhalational capacity, which can help in diagnosing asthma.

2. Official Description

The official description of CPT code 95070 is: ‘Inhalation bronchial challenge testing (not including necessary pulmonary function tests), with histamine, methacholine, or similar compounds.’

3. Procedure

1. The provider prepares the necessary substances, such as histamine or methacholine, for the bronchial challenge test.
2. The patient is instructed to inhale the test substance, which may cause the bronchioles to constrict.
3. The provider monitors the patient’s airway responsiveness and records any allergic reactions or changes in inhalational capacity.
4. After the test, the provider prepares a report documenting the results and findings.

4. Qualifying circumstances

The bronchial challenge test is typically performed on patients suspected of having asthma. It is used to assess airway responsiveness and detect any allergic reactions. The test does not include pulmonary function tests, which evaluate lung function in more detail. Providers who perform the bronchial challenge test should have the necessary expertise and equipment to administer and interpret the results accurately.

5. When to use CPT code 95070

CPT code 95070 should be used when performing the bronchial challenge test using substances like histamine or methacholine. It is appropriate for diagnosing asthma or assessing airway responsiveness in patients suspected of having asthma. However, it should not be used for pulmonary function tests, which require separate coding.

6. Documentation requirements

To support a claim for CPT 95070, providers must document the following information:

• Reason for performing the bronchial challenge test
• Substances used for the test, such as histamine or methacholine
• Date and time of the test
• Results of the test, including any allergic reactions or changes in inhalational capacity
• Provider’s interpretation of the results
• Preparation of a report summarizing the findings

7. Billing guidelines

When billing for CPT 95070, providers should ensure that the test is performed using substances like histamine or methacholine. Modifier 26 or TC should not be appended to this code, as it represents the technical component only. It is important to note that CPT 95070 does not include payment for pulmonary function tests, so additional codes may be necessary to evaluate lung function.

8. Historical information

CPT 95070 was added to the Current Procedural Terminology system on January 1, 1990. The code was last updated on January 1, 2021, with a revised description: ‘Inhalation bronchial challenge testing (not including necessary pulmonary function tests); with histamine, methacholine, or similar compounds.’

9. Examples

1. A patient suspected of having asthma undergoes a bronchial challenge test using histamine. The provider records the patient’s allergic reactions and changes in inhalational capacity.
2. During a diagnostic workup for asthma, a patient undergoes a bronchial challenge test with methacholine. The provider monitors the patient’s airway responsiveness and documents the results.
3. A provider performs a bronchial challenge test on a patient with suspected exercise-induced asthma. The patient inhales a substance, and the provider assesses the patient’s airway responsiveness.
4. As part of an allergy evaluation, a patient undergoes a bronchial challenge test using a specific antigen. The provider records any allergic reactions and changes in inhalational capacity.
5. A patient with suspected asthma undergoes a bronchial challenge test using a combination of histamine and methacholine. The provider monitors the patient’s airway responsiveness and documents the results.