Pulmonary Function Testing (94010-94799)
CPT codes for spirometry, lung volumes, diffusion capacity, and other pulmonary function tests.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Primary sources
- 2
- Workspace handoff
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Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
Each test has specific PE/TC components. Bundling rules per NCCI prevent billing all components separately when performed together.
How it shows up in your practice
Document the indication and the specific tests performed. Use modifier 59 only when separate testing is independently warranted.
Sources
- CMS — NCCIhttps://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits
- CMS — Physician Fee Schedulehttps://www.cms.gov/medicare/payment/fee-schedules/physician
Look up PFT bundling in Ask D3
Open ask d3 →Related terms
- BillingNCCI EditsThe CMS National Correct Coding Initiative edits that prevent improper payment when incorrect code combinations are reported.
- BillingModifier 59CPT modifier identifying a distinct procedural service that is not normally reported together but is appropriate under the circumstances.
- CodingMedical NecessityThe standard requiring that services be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryModifier 59CPT modifier identifying a distinct procedural service that is not normally reported together but is appropriate under the circumstances.
- GlossaryNCCI EditsThe CMS National Correct Coding Initiative edits that prevent improper payment when incorrect code combinations are reported.
- GlossaryMedical NecessityThe standard requiring that services be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
- GlossaryCardiac Stress Test (93015-93018)CPT codes for cardiac stress testing, with separate codes for the global service, supervision, and interpretation.
- GlossaryCharge CaptureThe process of identifying and recording every billable service furnished during a patient encounter.
- GlossaryClean Claim RatePercentage of claims accepted by the payer on first submission without edits or rejections.
- RegulationNCCI Modifier Overrides (Modifier 59 and X{EPSU})Modifier 59 (and its more specific subsets XE, XS, XP, XU) is the principal mechanism for overriding a PTP edit when a procedure is distinct or independent from another performed on the same day.
- BillingAWV + Problem Visit Same Day: How to Bill CorrectlyYes, you can bill AWV and a problem visit the same day. Here's how to do it correctly with modifier -25.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.