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Spirometry Testing in Primary Care

Chronic obstructive pulmonary disease (COPD) is a progressive, irreversible respiratory condition. According to the NIH, it is the third leading cause of the death in the United States.

Spirometry testing is recommended by the Global Initiative for Chronic Obstructive Lung Disease as the preferred method for diagnosing COPD. Despite spirometry being the gold standard for diagnosis and assessment of COPD, it remains underused in PCP settings.

Spirometry is a safe and practical procedure and primary care physicians/clinicians can be trained to provide these services.

CODING

  • J44.0 Chronic obstructive pulmonary disease with (acute) lower respiratory infection
  • J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
  • J44.9 Chronic obstructive pulmonary disease, unspecified

For spirometry performed in a primary care office, report 94010.

94010

Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation

94060

Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration

94070

Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (e.g., antigen[s], cold air, methacholine)

ADDITIONAL INFORMATION
The presence of symptoms is not a reliable indicator of COPD and diagnosis is often delayed until more severe airflow obstruction is present. The criterion for diagnosis defined in guidelines is based on the FEV1/FVC ratio forced expiratory ratio (FER) and its severity is based on forced expiratory volume in one second (FEV1) from measurements obtained during maximal forced expiratory maneuvers.

Early diagnosis using spirometry testing supports a treatment plan that may protect against worsening symptoms and decrease the number of exacerbations. In addition, early diagnosis allows risk factors for COPD, such as smoking, to be addressed promptly.

If you have any questions, call HPP’s Provider Services Helpline at 1-888-991-9023 (Monday–Friday, 9 a.m.–5:30 p.m.) or contact your HPP Network Account Manager (NAM).

Resources
October 20: Full letter to providers