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Know How To Differentiate Between The Two Codes For Pulmonary Stress Test

Finding it difficult to differentiate between the two codes for pulmonary stress test

? The key is to look for clues in their descriptions.

A doctor orders pulmonary stress testing on patients who complain of shortness of breath. The test allows the doctor to determine if the underlying cause is heart disease or lung disease. If you would have to code this test, there are two codes to choose from:

94620 -- Pulmonary stress testing; simple [example., six-minute walk test, prolonged exercise test for bronchospasm with pre- and post-spirometry and oximetry]

94621 -- Pulmonary stress testing; complex (including measurements of CO2 production, O2 uptake, and electrocardiographic recordings).


'Simple' and 'complex:

When you are coding 94620 and 94621, you would find that the words 'simple' and 'complex' differentiate one from the other. But then these words are not enough to look for hints. If you understood what the descriptors imply in detail, you could differentiate 94620 from 94621 more easily. For example, if documentation supports it, most six-minute walk tests can be coded as 94620 - a test performed for pulmonary assessment.

CPT Assistant indicates documentation should include heart rate, blood pressure, oxygen saturation, and liter flow of supplemental oxygen. Each of these should be recorded at rest, during exercise, and during recovery. CPT code 94620 also includes physician analysis of data, interpretation of the test, and a written report.

94621 constitutes a series of metabolic test

94621 involves measuring the integration of cardiac and pulmonology function, and the status of physical fitness. This includes measuring CO2 production, O2 uptake, and electrocardiographic recordings of the patient's response to the stress.

by: James Article
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