SpirOxCard® Spirometer / Pulse Oximeter
Reimbursement
2008 Spirometry Reimbursement 2008 Oximetry Reimbursement
Source: Medicare Physician's Fee Schedule for Calendar Year 2008
CPT Codes for Spirometry
The following common procedure terminology codes (CPT Codes) describe the various spirometric procedures and the national average reimbursement amount. They include, but are not limited to:
| CPT Code | Component Code |
Description | National Fee |
| 94010 | 00520, 94200, 94375, 95070, 95071 |
Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without MVV. | $34.12 |
| 94014 | 00520, 94010, 94015, 94016, 94200, 94375 |
Patient-initiated spirometric recording per 30 day period of time; includes reinforced education, transmission of spirometric tracings, data capture, analysis of transmitted data, periodic recalibration and physician review and interpretation. | $48.74 |
| 94015 | 00520, 94010, 94200, 94375 |
Patient-initiated spirometric recording per 30 day period of time; recording (includes hook up, reinforced education, data transmission, data capture, trend analysis and periodic recalibration). | $24.57 |
| 94016 | 00520, 94015, 94375 |
Patient-initiated spirometric recording per 30 day period of time; physician review and interpretation only. | $24.17 |
| 94060 | 00520, 36000, 36410, 94010, 94200, 94375, 94640, 94664, 94770, 95071 |
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration. |
$58.58 |
| 94200 | Maximum breathing capacity, maximal voluntary ventilation (MVV). | $22.96 | |
| 94375 | 00520 | Respiratory Flow Volume Loop. | $36.81 |
| 94620 | 00520, 93015, 93016, 93017, 93018, 93041, 93042, 94010, 94060, 94200, 94250, 94680, 94681, 94690, 94760, 94761, 94770 | Pulmonary stress testing; simple (eg, 6-minute walk test, prolonged exercise test for bronchospasm with pre- and post-spirometry and oximetry) | $89.12 |
ICD-9 Codes for Spirometry
The following ICD-9 Codes support the medical necessity for the use of a spirometer. They include, but are not limited to:
| 466 – 466.19 | Acute bronchitis andbronchiolitis |
| 490 | Bronchitis, not specified as acute or chronic |
| 491 – 491.9 | Chronic Bronchitis |
| 492 – 492.8 | Emphysema |
| 493 – 493.91 | Asthma |
| 494 | Bronchiectasis |
| 496 | Chronic airway obstruction, not elsewhere classified |
| 508 – 508.9 | Respiratory condition due to other and unspecified external agents |
| 518.9 | Other diseases of respiratory system, not elsewhere classified |
| 519.1 | Bronchospasm |
| 780.51 | Insomnia with sleep apnea |
| 786.2 | Cough |
| 780.53 | Hyperinsomnia with sleep apnea |
| 793.1 | Abnormal chest x-ray |
| 786 | Abnormal chest sounds |
| 277 | Cystic Fibrosis |
| 790.7 | Chronic fatigue |
| 787 | Heartburn |
| E942.9 | Other unspecified agents primarily affecting the cardiovascular system |
| 305.1 | History of tobacco abuse |
| V13.8 | History of thyroid disorder |
CPT Codes for Oximetry
The following common procedure terminology codes (CPT Codes) describe the various pulse oximetry procedures and the national average reimbursement amount. They include, but are not limited to:
Note that the same provider cannot bill for oximetry on the same day that another billable procedure has been provided.
| CPT Code |
Component |
Description | National Fee |
| 94760 | 82803, 82805, 94762 |
Noninvasive ear or pulse oximetry for oxygen saturation; single determination. | $2.62 |
| 94761 | 82803, 82805, 94760, 94762 |
Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (Example: During Exercise). | $5.54 |
| 94762 | 82805 | Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure). | $28.84 |
| 94620 |
00520, 93015, 93016, 93017, 93018, 93041, 93042, 94010, 94060, 94200, 94250, 94680, 94681, 94690, 94760, 94761, 94770 | Pulmonary stress testing; simple (eg, 6-minute walk test, prolonged exercise test for bronchospasm with pre- and post-spirometry and oximetry). | $89.12 |
| 94621 | Pulmonary stress testing; complex (including measurements of CO2 production, O2 uptake, and electrocardiographic recordings). | $157.11 |