2025 CPT code 94621
Effective Date: N/A Medicine - Pulmonary Procedures Feed
Cardiopulmonary exercise testing with minute ventilation, CO2 production, O2 uptake, and ECG recordings.
Modifiers 26 (professional component) and TC (technical component) are applicable.
Medical necessity for CPET must be established by demonstrating a clinical indication for the test, such as unexplained shortness of breath, chest pain, or decreased exercise tolerance.The test results must be used to guide treatment decisions and improve patient outcomes.
The physician performs the cardiopulmonary exercise test, interprets the results, and develops a treatment plan based on the findings.They monitor the patient's vital signs and ensure their safety throughout the procedure.This includes explaining the test to the patient, obtaining informed consent, and documenting the entire process.
In simple words: This is a breathing test done while you exercise. It checks how well your heart and lungs work when you are active. The doctor will monitor your heart, breathing, and blood levels while you walk on a treadmill or ride a stationary bike. This helps them understand if your heart and lungs are getting enough oxygen to your body during exercise.
Cardiopulmonary exercise testing (CPET) is a complex procedure used to evaluate heart and lung function during exercise. It involves measuring minute ventilation (the volume of gas inhaled or exhaled per minute), carbon dioxide (CO2) production, oxygen (O2) uptake, and electrocardiographic (ECG) recordings.The test helps assess how the cardiovascular, pulmonary, and metabolic systems respond to physical stress.It involves continuous ECG monitoring with chest electrodes and measurement of oxygen saturation, heart rate, blood pressure, and other physiological parameters. The patient typically exercises on a treadmill or stationary bike, with parameters measured during rest, exercise, and recovery. Blood samples are often taken to measure oxygen and carbon dioxide levels.
Example 1: A patient with shortness of breath during exercise undergoes CPET to evaluate for possible heart or lung conditions., A patient with chronic obstructive pulmonary disease (COPD) undergoes CPET to assess the severity of their lung disease and guide treatment decisions., An athlete undergoes CPET to assess their fitness level and identify potential areas for improvement.
Documentation should include the reason for the test, the patient's medical history, the type of exercise performed, the results of the measurements (minute ventilation, CO2 production, O2 uptake, ECG), and the physician's interpretation of the findings. Any adverse events during the test should also be documented.
- Modifier TC rule: Modifier TC is applicable if only the technical component is provided.
- Specialties:Pulmonary medicine, cardiology, sports medicine
- Place of Service:Office, Hospital (inpatient or outpatient), Independent Clinic, etc.