Internal Code Bundling

Does anyone have any knowledge of CMS guidelines regarding the following:

Our physician orders a Spiro (94010), Lung Volume (94727) and DLCO (94729), which is bundled into one code internally (e.g. PFT0045)

Billing goes out as three separate codes (see the above codes) with the appropriate diagnoses

Tests are resulted in one note, rather than individually

This is to save time for our doctors. Rather than clicking three orders and resulting three tests, it would be one. This bundled code would only be used by our group internally. The billing would go out the door correctly to the carrier.

Does anyone see a problem with this?


  • edited May 2017
    I see no problem with that. If the services billed are documented, then you're good. CMS does not state that diagnostic tests each need to be documented on a separate document/note. It's like labs, they list results for multiple lab tests on the same page. I have a pulmonologist and they do PFTs and the documentation is one document; multiple pages but one document.

  • No, if your logic is set up to capture all three if they are doing those three just make sure you don't need modifiers

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