Billing and Coding: Transtelephonic Spirometry

This billing and coding guidance for transtelephonic spirometry emphasizes proper coding, documentation, and use of ABN-related modifiers. Claims must include a valid ICD-10 diagnosis and, when applicable, the referring/ordering physician's name and NPI, signed medical records, and documentation of data transmission; specific ABN modifiers (GA, GX, GZ, GY) determine expected denials and associated requirements such as Form CMS-R-131 and occurrence code 32. Providers must check NCCI and OPPS edits prior to billing and use the specified FQHC bill types (73X before 2010-04-01, 77X on/after 2010-04-01) when applicable.

"A claim submitted without a valid ICD-10-CM diagnosis code will be returned as an incomplete claim under Section 1833(e) of the Social Security Act."

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