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Coding Q&A

Billing for Incentive Spirometry


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Q: A physician's office has called us regarding the billing of "incentive" spirometry. I cannot find a reimbursable code. Will Medicare or any other insurance actually pay for incentive spirometry for home use?

A: If the physician's office wants to know how they would get paid for providing patients with an incentive spirometer, they would have to become a DME supplier in order to get paid by Medicare. If they're looking for a code to pay for teaching the use of incentive spirometers, the only code that even comes close is 94664, which is demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler, or IPPB device. Incentive spirometers don't fit into the category of these types of devices. Teaching a patient on incentive spirometer use is part of a visit and not payable separately.

Ray Cathey, PA-C, MHA, FAHC, CHCC, is the president/owner of Medical Management Dimensions in Stockton, Calif.


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