Summary & Overview
CPT 94060: Bronchodilation Responsiveness Testing with Spirometry
CPT code 94060 is a critical procedure in pulmonary medicine, used to assess bronchodilation responsiveness through spirometry before and after bronchodilator administration. This test is widely utilized in outpatient settings to evaluate lung function in patients with asthma, chronic obstructive pulmonary disease (COPD), and other respiratory conditions. The code is recognized by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare, ensuring broad coverage for patients across the United States.
This publication provides a comprehensive overview of CPT code 94060, including its clinical significance, payer coverage, and associated billing practices. Readers will gain insight into relevant modifiers such as 26 (Professional Component) and TC (Technical Component), as well as the typical clinical scenarios and diagnoses linked to this procedure. The article also highlights related CPT codes for pulmonary function testing, offering context for how 94060 fits within broader respiratory diagnostic workflows. Key policy updates and benchmarks are discussed to inform stakeholders about current trends and requirements in medical billing and reimbursement for pulmonary diagnostic services.
Healthcare professionals, billing specialists, and policy analysts will find this summary useful for understanding the national landscape of coverage, coding, and clinical application for bronchodilation responsiveness testing.
CPT Code Overview
CPT code 94060 represents the assessment of bronchodilation responsiveness using spirometry, performed both before and after the administration of a bronchodilator. This procedure is a key component of pulmonary diagnostic testing and therapies, providing valuable information about airway function and response to treatment. The typical site of service for this test is an office setting, such as an outpatient pulmonary function laboratory. The test is commonly used to evaluate patients with respiratory symptoms or conditions, helping clinicians determine the effectiveness of bronchodilator therapy and guide further management.
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient pulmonary function lab with symptoms such as shortness of breath, wheezing, or cough. The clinician suspects a condition like asthma or chronic obstructive pulmonary disease (COPD). To assess airway responsiveness, spirometry is performed before and after administration of a bronchodilator. The results help determine the degree of reversible airway obstruction and guide further management. This workflow is typical for patients with suspected or known obstructive lung diseases.
Coding Specifications
-
Modifiers:
26: Professional Component – Used when only the physician's interpretation and report are billed, not the technical performance.TC: Technical Component – Used when only the technical performance of the test is billed, not the physician's interpretation.
-
Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207RP1000X | Pulmonary Disease (Pulmonology) |