Pulmonary Function Testing: Coding and Billing Issues

Abstract

Clinicians who conduct pulmonary function tests should understand the principles and rules of the coding and billing system for pulmonary function testing. Certain billing codes will not be paid by most insurance payers. To ensure that your pulmonary function tests are appropriately coded, billed, and paid: (1) obtain a Current Procedural Terminology (CPT) coding book and an International Classification of Diseases 9th Revision (ICD-9) diagnosis book, and understand how they are used in setting coding and billing strategies, (2) know the people in your facility who do the billing and work with them to produce an appropriate coding and billing strategy, (3) make sure the physicians are involved in developing and implementing your coding and billing strategy, and (4) assure that your laboratory is set up properly to follows the Medicare rules for participation, that you have the appropriate testing supervision, that the appropriate administrative structure is in place to assure compliance with all regulations, and that you meet American Thoracic Society testing standards.