Pulmonology, coding reference.
Office spirometry, pulmonary function testing, bronchoprovocation, sleep medicine. Spirometry is one of the most under-coded ancillaries in primary-care-adjacent practices because the bronchodilator add-on gets forgotten.
Selected reference codes
A curated selection, not a utilization ranking. Open a code for documentation requirements, modifiers, and pitfalls.
| Code | Description | wRVU | Total RVU | Medicare $ | |
|---|---|---|---|---|---|
| 99214 | Office o/p est mod 30 min 99214 is the workhorse of primary care and most outpatient subspecialties. Use it when at least one of these is true: two or more chronic problems with progression, treatment changes, or side effects; one undiagnosed new problem with uncertain prognosis; one acute illness with systemic symptoms; or prescription drug management at any complexity. Prescription drug management on its own satisfies the moderate-risk element, which is why straightforward chronic disease follow-ups with a med adjustment routinely clear the 99214 bar. Time-based alternative is 30 to 39 minutes of total time on the date of the encounter. Pick the method that supports the strongest note: encounters with prescription changes are usually cleaner under MDM; encounters with extensive counseling or care coordination are usually cleaner under time. | 1.92 | 4.06 | 136 | Details → |
| 99215 | Office o/p est hi 40 min Select this level when at least two of the three MDM elements meet high complexity, or when qualifying total time reaches 40 minutes. A diagnosis, medication, or high-risk decision alone does not establish the overall level. For Medicare prolonged services with this time-selected base code, the first G2212 unit requires 69 minutes. Payers recognizing CPT 99417 use different thresholds. | 2.80 | 5.76 | 192 | Details → |
| 94010 | Breathing capacity test Baseline office spirometry. Use 94060 if you give bronchodilator and repeat. | 0.17 | 0.89 | 30 | Details → |
| 94060 | Evaluation of wheezing Pre- and post-bronchodilator spirometry. The 'asthma confirmation' code. | 0.21 | 1.30 | 43 | Details → |
| 94375 | Respiratory flow volume loop Flow-volume loop testing for upper-airway obstruction evaluation. | 0.30 | 1.26 | 42 | Details → |
| 94640 | Airway inhalation treatment In-office nebulized albuterol or saline induction. | 0.00 | 0.26 | 9 | Details → |
| 94660 | Cpap initiation&mgmt CPAP initiation visit or follow-up management. | 0.74 | 2.07 | 69 | Details → |
| 95810 | Polysom 6/> yrs 4/> param In-lab attended polysomnography. Use 95811 if titration also performed. | 2.44 | 20.17 | 674 | Details → |
| 95806 | Sleep study unatt&resp efft Home sleep apnea test (unattended). | 0.91 | 3.09 | 103 | Details → |
| 94726 | Plethysmography lung volumes Body plethysmography for TLC, RV, FRC measurement (full PFT). | 0.25 | 1.91 | 64 | Details → |
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