94726 Body plethysmography Medicare reimbursement rates in Missouri

During body plethysmography, the patient sits in a sealed body box and pants against a temporarily closed mouthpiece shutter. Pressure changes establish thoracic gas volume; the laboratory combines this measurement with spirometric values to derive functional residual capacity, residual volume, and total lung capacity. Airway resistance and conductance measured as part of plethysmography are included. Respiratory therapists or pulmonary function technologists perform the study in office or hospital pulmonary function laboratories, and a pulmonologist typically interprets it. Clinicians order it to investigate suspected restriction after a low vital capacity or to assess hyperinflation and air trapping in COPD or asthma.

Report one unit for a plethysmographic lung volume study; use 94727 instead when volumes are measured by gas dilution or washout. Document the method, quality of the maneuvers, measured volumes, and interpretation. CMS recognizes a professional component for physician interpretation (modifier 26) and a technical component for equipment and staff (modifier TC); an entity furnishing both bills the global service without a modifier. For a hospital outpatient test, the physician reports the interpretation with modifier 26, while the hospital bills its facility service. Diffusing capacity, when performed, is separately reported with add-on code 94729.