Wiki Documentation requirements to bill 94010 vs. billing 94375

I'm trying to location "documentation requirements" regarding 94010 vs. 94375. As luck would have it the MedLearn email for today had a Q&A regarding the coding but had a link to a "Coding Essentials for Respiratory Therapy/Pulmonary Function. Does anyone have anything close to documentation requirements for the 2 codes ??

It appears you are in Illinois and your Part B MAC is NGS for MAC jurisdiction 6 and I did not find any Billing and Coding Articles or LCDs for NGS, my Part B MAC is Noridian MAC jurisdiction F and on CMS.gov there is a Billing and Coding Article for Respiratory Care A57225, which has a fairly thorough section regarding Noridian's documentation requirements. Obviously, this guidance doesn't apply to Illinois for Part B services, but it may provide you with the information you are seeking.

jason.lang said:

I'm trying to location "documentation requirements" regarding 94010 vs. 94375. As luck would have it the MedLearn email for today had a Q&A regarding the coding but had a link to a "Coding Essentials for Respiratory Therapy/Pulmonary Function. Does anyone have anything close to documentation requirements for the 2 codes ??

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Hi Jason
In the CPT manual year 2024 pg 819 explains the difference and not to mesh with add on code CPT 94375 with CPT 94010. It seems kind of redundant processes it is bundled in. The CPT 94375 is a flow volume loop .That seems to be involved in the CPT 94010 Spirometry test. Well that is my two cents..hope it is helpful
Lady T