Respiratory Question for the Week of April 10, 2017


Can code 94010 and 95070 be reported together on a claim for spirometry?


Under Medicare policy, if you submit both of these codes, you will only receive payment for one of the codes because they are “mutually exclusive procedures” (MEP) under the National Correct Coding Initiative policy. Briefly, mutually exclusive means that the procedures identified by the codes would not typically be performed during the same encounter, which is why they are called mutually exclusive. There may, however, be clinical circumstances that justify the use of a modifier, according to the Centers for Medicare & Medicaid Services.


CPT® copyright 2022 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.