Respiratory Question for the Week of April 10, 2017

Question:

Can code 94010 and 95070 be reported together on a claim for spirometry?

Answer:

Under Medicare policy, if you submit both of these codes, you will only receive payment for one of the codes because they are “mutually exclusive procedures” (MEP) under the National Correct Coding Initiative policy. Briefly, mutually exclusive means that the procedures identified by the codes would not typically be performed during the same encounter, which is why they are called mutually exclusive. There may, however, be clinical circumstances that justify the use of a modifier, according to the Centers for Medicare & Medicaid Services.

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