Question:

Is physician office-based spirometry covered by Medicare?

Answer:

According to the American Association of Respiratory Care (AARC), physician office-based spirometry is covered if it meets the criteria stated in the code description below, produces a tracing, and measures all the elements mentioned.

94010 Spirometry, including graphic tracing, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation (Do not report 94010 with 94150, 94200, 94375, 94728.)

AARC also says, “If conducting spirometry on the same day as a scheduled office visit, modifier 25 should be appended to the appropriate E/M code to indicate that the E/M service is a separately identifiable service from spirometry, e.g., 99213-25 plus 94010.”

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