94060

Bronchodilation responsiveness; spirometry as described in 94010, pre- and post-bronchodilator administration

CPT code 94060 describes a diagnostic pulmonary function test used to assess the presence and reversibility of airflow obstruction. The procedure involves conducting a complete spirometry test both before and after the administration of a bronchodilating medication. Initially, a baseline (pre-bronchodilator) spirometry is performed to measure dynamic lung volumes and flow rates, including Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), and the FEV1/FVC ratio. The patient is required to take a deep breath and exhale as hard and fast as possible into the spirometer. Following the baseline measurement, a short-acting bronchodilator, such as albuterol, is administered via a metered-dose inhaler or nebulizer. After a waiting period of approximately 10 to 20 minutes to allow the medication to take effect, the spirometry maneuvers are repeated (post-bronchodilator). The primary clinical utility of this test is to determine if the patient's airflow obstruction is 'reversible,' which is typically defined by an increase in FEV1 of more than 12% and 200 mL compared to the baseline. This finding is highly suggestive of asthma. Conversely, if the obstruction remains relatively unchanged, it may indicate Chronic Obstructive Pulmonary Disease (COPD) or other forms of fixed airway disease. The code 94060 encompasses both the pre- and post-testing, the administration of the medication, and the calculation of the responsiveness index by a qualified healthcare professional.

Clinical Indications

  • Diagnosis of asthma
  • Evaluation of Chronic Obstructive Pulmonary Disease (COPD)
  • Assessment of chronic cough of unknown etiology
  • Monitoring effectiveness of long-term bronchodilator therapy
  • Differentiation between reversible and irreversible airway obstruction
  • Evaluation of shortness of breath or dyspnea
  • Preoperative pulmonary assessment in patients with known lung disease
  • Work-related or environmental exposure health screening

Procedure Steps

  1. Explain the procedure to the patient and ensure they have not used short-acting bronchodilators recently.
  2. Measure patient height and weight for predicted value calculations.
  3. Perform baseline (pre-bronchodilator) spirometry using at least three acceptable and repeatable maneuvers.
  4. Record FVC, FEV1, and peak expiratory flow (PEF) values.
  5. Administer the bronchodilating agent (e.g., 2-4 puffs of Albuterol via MDI or via nebulization).
  6. Provide a 10 to 20-minute rest period to allow for pharmacological action.
  7. Perform the post-bronchodilator spirometry repeating the maximal expiratory maneuvers.
  8. Calculate the percentage and absolute change in FEV1 and FVC between pre- and post-medication results.
  9. Physician reviews the flow-volume loops and numerical data to provide an interpretation.

Coding Guidelines

  • Do not report 94060 in conjunction with 94010 (simple spirometry) as 94060 includes the components of 94010.
  • The cost of the bronchodilator medication used (e.g., J7611, J7613) should be reported separately.
  • If the test is performed in a facility or hospital, use modifier 26 for the professional component (interpretation) or TC for the technical component.
  • CPT 94060 should not be reported on the same day as 94070 (bronchospasm provocation) unless specifically required for distinct diagnostic purposes and supported by documentation.
  • Ensure documentation includes the pre-medication values, post-medication values, and the percentage of change to justify the use of 94060 over 94010.

Associated ICD-10 Codes