Pulmonary diagnostic testing and therapies play a crucial role in assessing and treating respiratory conditions. To standardize the reporting of these procedures, the Current Procedural Terminology (CPT) codes provide a structured system. In this article, we will explore some common CPT codes (and its description*) associated with pulmonary diagnostic testing and therapies, including bronchoscopy, thoracentesis, pulmonary function tests (PFTs), exercise stress testing, polysomnography/sleep studies, thoracoscopy, and lung biopsy. Understanding these codes is essential for accurate documentation and billing in the field of pulmonary medicine.
CPT Codes for Pulmonary Diagnostic Testing and Therapies
1. Bronchoscopy
Bronchoscopy is a procedure that allows visualization and examination of the airways. Several CPT codes are associated with different aspects of bronchoscopy:
- 31622: A diagnostic bronchoscopy, either rigid or flexible, including fluoroscopic guidance when performed, and with cell washing when performed (separate procedure).
- 31623: A bronchoscopy procedure, either rigid or flexible, including fluoroscopic guidance when performed, specifically with brushing or protected brushings.
- 31624: A bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed; with bronchial alveolar lavage.
- 31625: A bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed; with bronchial or endobronchial biopsy(s), single or multiple sites.
- 31628: A bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed, with transbronchial lung biopsy(s), single lobe.
2. Thoracentesis
Thoracentesis is a procedure performed to remove fluid or air from the pleural space surrounding the lungs. The following CPT codes are relevant to thoracentesis:
- 32554: Thoracentesis, needle or catheter, aspiration of the pleural space: This code is used when fluid or air is aspirated from the pleural space using a needle or catheter.
- 32555: Thoracentesis, with insertion of a tube or catheter: If a tube or catheter is inserted into the pleural space for ongoing drainage or therapeutic purposes, this code is reported.
3. Pulmonary Function Tests (PFTs)
Pulmonary function tests assess lung function and help diagnose respiratory disorders. Several CPT codes are associated with different types of PFTs:
- 94010: Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation: This code represents the measurement of lung volumes and airflow rates during spirometry, a commonly performed PFT.
- 94060: Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration: When spirometry is performed before and after the administration of a bronchodilator medication to assess bronchodilator responsiveness, this code is used.
- 94375: Diffusion capacity (e.g., carbon monoxide, membrane diffusion capacity), single breath: This code is used when the diffusion capacity of the lungs is measured, typically by assessing the transfer of carbon monoxide across the alveolar-capillary membrane.
4. Exercise Stress Testing
Exercise stress testing evaluates lung function and cardiovascular response during physical exertion. The relevant CPT code is:
- 94620: Pulmonary stress testing (e.g., 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration when performed: This code represents the performance of a pulmonary stress test, such as the 6-minute walk test, which measures exercise capacity and oxygen saturation during physical activity.
5. Polysomnography/Sleep Studies
Polysomnography involves the monitoring and evaluation of various physiological parameters during sleep. The following CPT codes are related to sleep studies:
- 95806: Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoracoabdominal movement).
- 95807: Sleep study, attended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoracoabdominal movement).
6. Thoracoscopy
Thoracoscopy is a surgical procedure that allows for visualization and treatment of the pleural space and thoracic organs. The associated CPT codes are:
- 32601: Thoracoscopy, diagnostic (separate procedure): This code represents a diagnostic thoracoscopy, which involves the visual examination of the pleural space and thoracic structures.
- 32604: Thoracoscopy, surgical; with biopsy: If a biopsy is performed during a surgical thoracoscopy, this code is utilized to report the procedure.
7. Lung Biopsy
Lung biopsies involve the collection of tissue samples from the lungs for diagnostic or therapeutic purposes. The relevant CPT code is:
- 32405: Biopsy, lung or mediastinum, percutaneous needle: This code represents a percutaneous needle biopsy of the lung or mediastinum, where a needle is inserted through the skin to obtain tissue samples.
To conclude, accurate coding of pulmonary diagnostic testing and therapies is vital for effective communication, appropriate reimbursement, and maintaining medical records. It is important to note that coding guidelines may evolve, and specific circumstances may require additional codes or modifiers. Healthcare professionals and medical coders should stay updated with the latest coding guidelines and seek expert advice to ensure accurate reporting and adherence to regulatory requirements. By utilizing the appropriate CPT codes, healthcare providers can effectively communicate the pulmonary diagnostic testing and therapies performed, facilitating optimal patient care and efficient reimbursement processes.
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*CPT is a registered trademark of the American Medical Association (AMA).
Disclaimer: This article is for informational purposes only and not professional billing or coding advice. While we strive for accuracy, coding guidelines, and payer policies may change. Medisys is not responsible for any errors or outcomes resulting from the use of this information.
*Please note that while these CPT code descriptions are based on the latest available information, CPT codes and their definitions can change annually. For the most accurate and up-to-date information, it’s recommended to consult the current year’s CPT manual or an official coding resource.
