The most popular pulmonary function test otherwise known as the “Spirogram” test requires data from both a volume-time curve and a flow-volume curve, which will require your spirometer to have a full flow volume loop and interpretation in order to properly conduct a pulmonary function or stress function test.
Fortunately for physicians, spirometers are quickly becoming more advanced and cheaper as technology in medical industry progresses.
Physicians can now purchase brand new spirometers with full flow volume loop, factory precalibrated turbines, and interpretation for as low as $495 ensuring that the physician can pay for their spirometer within one to three months if they capitalize on government reimbursements through doing only one pulmonary function test per day (depending on geographic location).
If that same physician decides to do the six minute walk stress test, they can double their reimbursements guaranteeing that the brand new spirometer is paid off in half the time.
As most clinicians know, reimbursements are provided to those who perform the proper pulmonary function tests with the corresponding diagnosis and treatment. In order to receive payment, clinicians need to understand the procedures and rules of the coding and billing system set in place because certain billing codes will not receive payment by many insurance payers. Take these three steps into account when conducting pulmonary test to ensure payment:
1) Know the Current Procedural Terminology (CPT) codes associated to pulmonary tests and the International Classification of Diseases Revision 9 (ICD-9) codes that go along with it. Understanding how to properly use these codes with billing is key to making sure you receive payment. More information on the coding system can be found at https://apps.ama-assn.org
2) Once you understand the coding system or at least know the proper codes for your practice, you need to make sure the people who work in billing understand the coding process as well so when insurance companies are billed your claim will not be denied.
3) Lastly, make sure your laboratory follows the Medicare rules for participation, that you have appropriate testing supervision, that you comply with all regulations and you must meet American Thoracic Society testing standards.
