Summary & Overview
CPT 94617: Exercise‑Induced Bronchospasm Test with Cardiopulmonary Assessment
CPT code 94617 represents diagnostic exercise testing to assess exercise‑induced bronchospasm and associated cardiopulmonary response. This code captures procedures that evaluate pulmonary function during physical exertion to diagnose exercise‑related asthma and other exertional lung disorders; cardiac function is also assessed to some extent during the test. Nationally, accurate coding for this service matters for appropriate clinical tracking, care coordination between pulmonology and cardiology, and consistent reimbursement for diagnostic services performed in outpatient and hospital settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, common modifiers used with this code, and what to expect in terms of payer coverage considerations. The publication provides benchmarks and policy context where available, clarifies typical sites of service, and summarizes clinical indications tied to exercise‑induced bronchospasm testing.
Data not available in the input for associated taxonomies, specific ICD‑10 diagnoses, and related codes. The content focuses on national clinical and billing context rather than state‑specific rules.
Billing Code Overview
CPT code 94617 describes a test performed to assess exercise‑induced bronchospasm with evaluation of lung function during exertion. The procedure evaluates airway response to exercise to help diagnose or characterize exercise‑related asthma and other exertional pulmonary disorders, and includes assessment of some degree of cardiac function during the exercise testing.
Service type: Diagnostic exercise bronchoprovocation testing with cardiopulmonary monitoring
Typical site of service: Hospital outpatient department, pulmonary function laboratory, or ambulatory diagnostic testing center
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 14–35 year old athlete or otherwise physically active individual who reports exertional shortness of breath, chest tightness, wheeze, or unexplained decline in exercise tolerance. The clinician orders exercise-induced bronchospasm testing to reproduce symptoms under monitored conditions and to evaluate airway responsiveness and some degree of cardiac function during exercise. The workflow: the patient arrives fasting per local protocol, baseline spirometry and vital signs are obtained, pre-test medication withholding is confirmed, and a symptom review and focused cardiopulmonary exam are documented. The patient performs a standardized exercise challenge (treadmill or cycle ergometer) under continuous monitoring; serial spirometry is performed at defined intervals post-exercise to quantify fall in FEV1 consistent with bronchospasm. Cardiac rhythm and hemodynamics are observed during and after exercise; test endpoints, interventions (bronchodilator administration), and patient tolerance are documented. Results guide diagnosis (exercise-induced bronchoconstriction, asthma) and treatment planning. Typical sites of service: hospital outpatient pulmonary function lab, freestanding pulmonary function laboratory, or ambulatory clinic with exercise testing capability. The service corresponds to 94617.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure |