Summary & Overview

HCPCS G8925: Spirometry Interpretation — FEV1 ≥60% and FEV1/FVC ≥70%

HCPCS Level II code G8925 is used to report spirometry results that indicate preserved lung function — specifically, FEV1 at or above 60% of predicted and an FEV1/FVC ratio at or above 70% — or to note the absence of COPD symptoms. This code matters nationally as spirometry interpretation guides diagnosis, disease surveillance, and care pathways for respiratory conditions, influencing clinical decision-making and utilization management across payers. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise overview of how G8925 is applied in clinical documentation and billing, typical sites of service for the test, and the clinical context of spirometry thresholds used to rule out obstructive disease. The publication outlines common modifiers and payer coverage patterns where available, operational considerations for coding and claims submission, and how G8925 fits into pulmonary function testing service lines. It also summarizes relevant benchmarks and policy updates when present. Data not available in the input is clearly noted where necessary.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG8925HCPCS Level IIspirometrypulmonary function testingFEV1FEV1/FVCrespiratory diagnosticsoutpatient servicesclinical interpretation

Billing Code Overview

HCPCS Level II code G8925 indicates that spirometry test results demonstrate FEV1 ≥ 60% and FEV1/FVC ≥ 70%, predicted, or the patient does not have COPD symptoms. This code describes the clinical interpretation of spirometric measurements used to assess airflow limitation and exclude obstructive lung disease in symptomatic evaluation.

Service Type: Pulmonary function testing interpretation

Typical Site of Service: Outpatient clinic or pulmonary function laboratory, including primary care or specialty respiratory clinics where spirometry is performed and interpreted.

Clinical & Coding Specifications

Clinical Context

A 58-year-old adult attends a primary care clinic for evaluation of chronic cough and dyspnea. The clinician orders spirometry to assess airflow obstruction and to screen for obstructive lung disease. The spirometry is performed by trained respiratory therapy staff in an outpatient pulmonary function lab within the clinic. Pre-test instructions include withholding short-acting bronchodilators per protocol. The test demonstrates forced expiratory volume in one second (FEV1) ≥ 60% predicted and an FEV1/FVC ratio ≥ 70% predicted, and the patient does not report symptoms consistent with chronic obstructive pulmonary disease (COPD). Results are documented in the electronic health record and routed to the ordering clinician for interpretation and follow-up. Typical sites of service include outpatient clinic pulmonary function laboratories, primary care offices with on-site spirometry equipment, and ambulatory diagnostic centers. Common clinical workflows include patient registration, pre-test screening, technician-performed spirometry with coaching, quality review by the performing clinician or respiratory therapist, and result reporting with possible referral to pulmonology if abnormalities are identified or if symptoms persist.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when spirometry required significantly greater effort, time, or technical difficulty than usual and documentation supports increased intensity.
`23`	Unusual anesthetic	Rarely used for spirometry; applicable if anesthesia is administered for an unusually painful diagnostic procedure associated with testing.
`52`	Reduced services	Use when spirometry is partially reduced or not completed per intended protocol but still billed at a reduced level.
`53`	Discontinued procedure	Use when spirometry is started but discontinued due to patient instability or test intolerance.
`54`	Surgical care only	Not typically used for spirometry; included when procedure portion is performed separate from global surgical care.
`55`	Postoperative management only	Not typically applicable to spirometry; used when postoperative services only are provided.
`56`	Preoperative management only	Not typically applicable; use when preoperative evaluation only occurs and spirometry is part of that preop assessment.
`62`	Two surgeons	Not applicable to spirometry; used when two surgeons perform distinct parts of a procedure.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for surgical assist	Not typical for spirometry but used if an advanced practitioner assists in an associated surgical procedure.
`CO`	Items or services furnished as part of a workers' compensation case	Use when spirometry is performed for a work-related claim and payor requires this modifier.
`CQ`	Telehealth originating site facility fee billing	Use when applicable for telehealth-related facility fees tied to the diagnostic encounter.
`FX`	Modifiers for modifiers (carrier-specific)	Rarely used; follow payer guidance when multiple modifiers require nesting.
`FY`	Professional component charging and reporting	Use when only the professional component (interpretation) of a diagnostic test is billed separately and allowed by payor.
`QK`	Medical direction of two, three, or four assistants	Not typically applicable to spirometry; used when medical direction rules apply for assistants.
`QX`	CRNA service with medical direction by physician	Not applicable to routine spirometry; used when CRNA services are billed under medical direction.

Taxonomy Code	Specialty	Notes
`207RP1000X`	Pulmonary Disease	Pulmonologists commonly interpret spirometry and manage obstructive/restrictive lung disease.
`207RH0000X`	Sleep Medicine	Sleep physicians may order spirometry as part of pre-evaluation for sleep-disordered breathing management.
`207RC0000X`	Internal Medicine	Primary care and internists commonly order and review spirometry for screening and initial evaluation.
`363L00000X`	Respiratory Therapy	Respiratory therapists perform spirometry testing and ensure quality control.
`103T00000X`	Family Medicine	Family physicians frequently order spirometry in the outpatient setting for chronic respiratory complaints.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J44.9`	Chronic obstructive pulmonary disease, unspecified	Common reason to perform spirometry to assess airflow obstruction severity and guide management.
`J45.909`	Unspecified asthma, uncomplicated	Spirometry is used to diagnose and monitor asthma and to assess bronchodilator response.
`R05`	Cough	Common presenting symptom prompting spirometry to evaluate for obstructive disease.
`R06.02`	Shortness of breath	Dyspnea is an indication for spirometry to evaluate pulmonary function.
`Z13.6`	Encounter for screening for respiratory tuberculosis — screening (alternate screening code)	Screening encounters may include spirometry when assessing respiratory risk or baseline function.
`Z87.891`	Personal history of nicotine dependence	Smoking history is relevant to interpretation of spirometry and risk stratification for COPD.
`J98.4`	Other disorders of lung (e.g., unspecified chronic respiratory conditions)	Used when non-specific respiratory symptoms require spirometric evaluation.
`R91.8`	Other nonspecific abnormal finding of lung field	Abnormal imaging findings may prompt spirometry to assess functional impact.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`94010`	Bronchospasm evaluation; spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with interpretation and report	Commonly performed alongside or as an alternative spirometry code capturing basic spirometry with interpretation.
`94060`	Bronchospasm evaluation; quantitative measurement of lung volumes by plethysmography or other methods	Performed when lung volume assessment is needed after initial spirometry findings to clarify restrictive physiology.
`94729`	Carbon monoxide diffusion measurement (single-breath method)	Used when additional pulmonary function testing such as diffusing capacity (DLCO) is indicated following spirometry.
`94620`	Pulmonary stress testing -- spirometry and oxygen saturation during exercise	Performed when exercise-induced bronchoconstriction is suspected after baseline spirometry.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes	Often provided in the same visit when spirometry screens for obstructive disease and counseling is indicated.
`94070`	Bronchodilation responsiveness, spirometry as in `94010`, before and after bronchodilator	Performed during the same encounter when bronchodilator responsiveness testing is indicated to distinguish asthma from fixed obstruction.