Question:
My question relates to billing code 94250 (expired gas collection, quantitative, single procedure [separate procedure]). Do all Medicare payers cover this procedure, or is it determined by each individual payer?
Answer:
Some Medicare payers have stated that CPT code (94250) represents a procedure with no clinical applications (i.e., a research tool) and have published a policy stating that it is a non-covered service in their state.
Billing for the expired gas collection in addition to any of the respiratory therapy codes—94620, 94621, 94680 and 94681 as included in the National Correct Coding Initiative (NCCI) edits will result in double billing—and a claim denial. To report a determination for expired nitric oxide, refer to CPT code 95012.
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