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Official Description

Inhalation bronchial challenge testing (not including necessary pulmonary function tests), with histamine, methacholine, or similar compounds

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

An inhalation bronchial challenge test is a diagnostic procedure primarily utilized in the evaluation and management of asthma. This test involves the use of a nebulizer, which is a device that converts liquid medication into a mist, allowing the patient to inhale specific concentrations of compounds such as histamine, methacholine, or similar agents. During the procedure, the patient inhales the mist for a designated duration, after which they exhale forcefully into a spirometer. The spirometer is an instrument that measures the volume of air inhaled and exhaled, as well as the timing of these breaths. The results from the spirometer are graphically represented, providing a visual depiction of the patient's respiratory function. Throughout the test, the concentration of the inhaled compound may be modified to elicit a bronchial response, which is indicative of airway hyperreactivity. If adjustments to the concentration are made, the patient will inhale the mist again for a specified time, followed by additional spirometric measurements. The physician is responsible for reviewing and interpreting the data collected from the bronchial challenge test, including the spirometer readings, and subsequently generates a written report detailing the findings. This procedure is critical for understanding the patient's respiratory status and guiding further management of asthma or related conditions.

© Copyright 2026 Coding Ahead. All rights reserved.

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1. Indications

The inhalation bronchial challenge test is indicated for the following conditions:

  • Asthma Diagnosis This test is performed to confirm or rule out a diagnosis of asthma in patients presenting with respiratory symptoms.
  • Assessment of Airway Hyperreactivity It is used to evaluate the sensitivity of the airways to various bronchoconstrictors, which is a characteristic feature of asthma.
  • Monitoring Asthma Management The test can help assess the effectiveness of asthma management strategies and medications by determining the patient's response to inhaled bronchial challenge agents.

2. Procedure

The inhalation bronchial challenge test involves several key procedural steps that ensure accurate assessment of the patient's respiratory function:

  • Preparation of the Patient The patient is first prepared for the test, which may include obtaining a detailed medical history and ensuring that they have not used bronchodilators or other medications that could affect the results prior to the test.
  • Administration of the Testing Compound A nebulizer is utilized to disperse a mist containing a specific concentration of histamine, methacholine, or a similar compound. The patient is instructed to inhale this mist deeply for a prescribed duration, allowing the compound to reach the bronchial passages.
  • Spirometric Measurements After inhalation, the patient is required to exhale forcefully into a spirometer. This device measures the volume of air exhaled and the time taken for inhalation and exhalation. The spirometer provides critical data that reflects the patient's lung function.
  • Adjustment of Compound Concentration If necessary, the concentration of the inhaled compound may be adjusted during the test to provoke a bronchial response. The patient will inhale the mist again at the new concentration, followed by additional spirometric readings to assess any changes in lung function.
  • Data Interpretation The physician reviews the spirometric data and the patient's response to the bronchial challenge. This includes analyzing the changes in airflow and any symptoms experienced during the test.
  • Documentation of Findings Finally, the physician compiles a written report summarizing the findings of the bronchial challenge test, which is essential for further clinical decision-making and management of the patient's condition.

3. Post-Procedure

Post-procedure care for the inhalation bronchial challenge test typically involves monitoring the patient for any immediate adverse reactions to the inhaled compounds. Patients may experience transient bronchoconstriction or respiratory discomfort, which should be managed appropriately. It is important for the physician to provide the patient with guidance on any necessary follow-up actions based on the test results. Additionally, the physician may discuss the implications of the findings for the patient's asthma management plan, including potential adjustments to medications or further diagnostic evaluations if needed. Recovery time is generally minimal, and patients can usually resume normal activities shortly after the test, unless otherwise advised by the physician.

Short Descr INHLJ BRNCL CHALLENGE TSTG
Medium Descr INHLJ BRNCL CHALLENGE TSTG W/HISTAMINE/METHACHOL
Long Descr Inhalation bronchial challenge testing (not including necessary pulmonary function tests), with histamine, methacholine, or similar compounds
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 3 - Technical Component Only Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 02 - Procedure must be performed under the direct supervision of a physician.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Not Discounted when Multiple
Type of Service (TOS) 1 - Medical Care
Berenson-Eggers TOS (BETOS) T2D - Other tests - other
MUE 1
CCS Clinical Classification 173 - Other diagnostic procedures on skin and subcutaneous tissue
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
GX Notice of liability issued, voluntary under payer policy
GZ Item or service expected to be denied as not reasonable and necessary
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2025-01-01 Changed Short and Medium Descriptions changed.
2021-01-01 Changed Code changed.
Pre-1990 Added Code added.
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