LCD/NCD Portal

L29265 PULMONARY DIAGNOSTIC SERVICES

 

 

01/01/2012

 

 

Indications and Limitations of Coverage and/or Medical Necessity

 

Medicare will consider pulmonary diagnostic tests medically necessary for the indications outlined below.

(It is expected the provider of services will follow a thoughtful, purposeful sequence in his/her selection of tests appropriate to the patient’s presenting complaint, medical history, physical examination, etc.)

Indications

• Pulmonary diagnostic services will be considered reasonable and medically necessary when

o Ordered by the patient’s treating physician for a specific medical problem.

And

o When performed only by providers of pulmonary services or other providers who have specialized training and expertise in performing pulmonary diagnostic services.

• The CMS Manual System, Pub. 100-08, Program Integrity Manual, Chapter 13, Section 5.1 (http://www.cms.hhs.gov/manuals/downloads/pim83c13.pdf outlines that “reasonable and necessary" services are "ordered and/or furnished by qualified personnel."

o A qualified physician for this service/procedure is defined as follows:

 Physician is properly enrolled in Medicare.

 Training and expertise must have been acquired within the framework of an accredited residency and/or fellowship program in the applicable specialty/subspecialty in the United States or must reflect equivalent education, training, and expertise endorsed by an academic institution in the United States and/or by the applicable specialty/subspecialty society in the United States.

• All pulmonary diagnostic studies must be:

o Performed by a qualified physician.

o Performed under the general supervision of a qualified physician by a technologist who has demonstrated minimum entry level competency by being credentialed by a recognized national credentialing body such as the National Board for Respiratory Care (NBRC).

 In addition to receiving credentialing by a recognized national credentialing body, qualified technologists must have a state license.

• Examples of certification for pulmonary diagnostic testing by non-physician personnel include:

o Certified Pulmonary Function Technician (CPFT).

o Registered Pulmonary Function Technician (RPFT).

o Certified Respiratory Therapist (CRT).

o Registered Respiratory Therapist (RRT).

o Perinatal/Pediatric Care Specialist.

• In addition to credentialing requirements, a state license is required if mandated by the state/territory of the practicing clinician.

o In the absence of a state/territory licensing or credentialing process, documentation should be maintained by the supervising physician who demonstrates appropriate training of staff performing the services.

o This documentation should be available to Medicare upon request.

Limitations

• The use of pulmonary diagnostic function testing as part of the routine clinical exam is not covered under the Medicare benefit.

o In instances where studies are recommended as part of a preoperative evaluation in a patient with no active pulmonary symptoms, the record must document the rationale for the study (i.e.

 Long history of smoking.

 Asbestos exposure.

 Exposure to toxic drugs.

o Studies performed in the absence of such documentation will be considered NOT reasonable and medically necessary.

• Patient initiated spirometry (94014, 94015 and 94016) is non-covered and will not be reimbursed.

Pulmonary Function Tests

• PFTs measure two components of the respiratory system: the mechanical ability of the respiratory system to move air in and out of the lungs; and the effectiveness of the respiratory system in exchanging oxygen and carbon dioxide with the atmosphere. A PFT includes three possible components:

o Spirometry (94010, 94060, 94070).

o Lung Volume Determination (94250, 94726, 94727 and 94728).

 Lung Volume tests cannot be measured directly using Spirometry because these volumes and capacities include air that cannot be expelled from the lungs.

 Lung Volume is generally determined in one of four ways:

• Closed circuit helium equilibration.

• Open circuit nitrogen washout.

• Whole body plethysmography.

• Radiologic techniques.

o Diffusion Capacity Tests (94729).

• The PFT will be considered medically necessary for the following conditions:

• Preoperative evaluation of the lungs and pulmonary reserve when:

o Thoracic surgery will result in loss of functional pulmonary tissue. (i.e., lobectomy).

o Patients are undergoing major thoracic and/or abdominal surgery and the physician has some reason to believe the patient may have a pre-existing pulmonary limitation (e.g., long history of smoking).

o The patient’s pulmonary function is already severely compromised by other diseases such as chronic obstructive pulmonary disease (COPD).

• Initial diagnostic workup for the purpose of differentiating between obstructive and restrictive forms of chronic pulmonary disease.

o Obstructive defects (e.g., emphysema, bronchitis, asthma) occur when ventilation is disturbed by an increase in airway resistance.

o Expiration is primarily affected.

o Restrictive defects (e.g., pulmonary fibrosis, tumors, chest wall trauma) occur when ventilation is disturbed by a limitation in chest expansion. Inspiration is primarily affected.

 To assess the indications for and effect of therapy in diseases such as sarcoidosis, diffuse lupus erythematosus, and diffuse interstitial fibrosis syndrome.

 Evaluate patient’s response to a newly established bronchodilator anti-inflammatory therapy.

 To monitor the course of asthma and the patient’s response to therapy.

• (i.e., especially to confirm home peak expiratory flow measurements).

 Evaluate patients who continue to exhibit increasing shortness of breath (SOB) after initiation of bronchodilator anti-inflammatory therapy.

 Initial evaluation for a patient that presents with new onset (within 1 month) of one or more of the following symptoms: shortness of breath, cough, dyspnea, wheezing, orthopnea, or chest pain.

 Initial diagnostic workup for a patient whose physical exam revealed one of the following: overinflation, expiratory slowing, cyanosis, chest deformity, wheezing, or unexplained crackles.

 Initial diagnostic workup for a patient with chronic cough.

• It is not expected that a patient would have a repeat spirometry without new symptomatology.

• Re-evaluation of a patient with or without underlying lung disease who presents with increasing SOB (from previous evaluation) or worsening cough and related qualifying factors such as abnormal breath sounds or decreasing endurance to perform Activities of Daily Living (ADL’s).

o To establish baseline values for patients being treated with pulmonary toxic regimens (e.g., Amiodarone).

o To monitor patients being treated with pulmonary toxic regimens when any new respiratory symptoms (e.g., exertional dyspnea, non-productive cough, pleuritic chest pain) may suggest the possibility of pulmonary toxicity.

o To evaluate cystic fibrosis patients with pulmonary manifestations.

• It is expected that procedure code 94070 will only be performed to make an initial diagnosis of asthma.

• Also, it is expected that procedure code 94060 be utilized during the initial diagnostic evaluation of a patient.

o Once it has been determined that a patient is sensitive to bronchodilators, repeat bronchospasm evaluation is usually not medically necessary, unless one of the following circumstances exist:

 A patient is exhibiting an acute exacerbation and a bronchospasm evaluation is being performed to determine if the patient will respond to bronchodilators.

 The initial bronchospasm evaluation was negative for bronchodilator sensivity and the patient presents with new symptoms which suggest the patient has a disease process which may respond to bronchodilators.

 The initial bronchospasm evaluation was not diagnostic due to lack of patient effort. Repeat spirometries performed to evaluate patients’ response to newly established treatments, monitor the course of asthma/COPD, or evaluate patients continuing with symptomatology after initiation of treatment should be utilized with procedure code 94010.

• In addition, it is not expected that a pulse oximetry (procedure code 94760 or 94761) for oxygen saturation would routinely be performed with spirometry.

o Pulse oximetry is considered medically necessary when the patient has a condition resulting in hypoxemia and there is a need to assess the status of a chronic respiratory condition, supplemental oxygen and/or a therapeutic regimen. (e.g., acute symptoms).

• Usually during an initial evaluation, there is no reason to obtain a spirometry after the administration of bronchodilators in patients who have normal spirometry, normal flow volume loop and normal airway resistance unless there is reason to believe (e.g., symptoms, exam) that a patient has underlying lung disease.

• The residual volume (RV) cannot be measured by spirometry because this includes air that cannot be expelled from the lungs, and, therefore, is determined by subtracting the expiratory reserve volume (ERV) from the functional residual capacity (FRC).

o The FRC cannot be measured by simple spirometry either.

o Therefore, procedure code 94726 or 94727 will be performed when the RV and FRC need to be determined.

• The Maximum Voluntary Ventilation (MVV; procedure code 94200) is a determination of the liters of air that a person can breathe per minute by a maximum voluntary effort.

o This test measures several physiologic phenomena occurring at the same time.

o The results and success of this test are effort dependent, therefore, routine performance of this test is not recommended, except in cases such as:

 Pre-operative evaluation.

 Neuromuscular weakness.

 Upper airway obstruction.

 Suspicion of Chest Bellows disease.

• The Respiratory Flow Volume Loop (procedure code 94375) is used to evaluate the dynamics of both large and medium size airways.

o This test is more useful than the conventional spirogram.

o The procedure is the same for spirometry except for the addition of a maximal forced inspiration at the end of the force expiratory measures.

Pulmonary Stress Testing (94620, 94621)

• The pulmonary stress testing procedures range from simple to complex.

o The simple procedure (Stage 1) consists of BP, ECG, and ventilation measurements at timed increments during exercise.

o The complex procedure includes Stage 2 and Stage 3. Stage 2 involves all of Stage 1 measurements in addition to the mixed venous CO2 tension (production) by means of rebreathing technique and O2 uptake.

o Stage 3 requires the following:

 Blood gas sampling and analysis.

 An indwelling catheter is inserted into the brachial or radial artery.

 In addition to Stage 2 tests, measurements for cardiac output, alveolar ventilation, ratio of dead space to tidal volume, alveolar-arterial O2 tension difference, venous admixture ratio and lactate levels are determined.

• Exercise testing is done to evaluate functional capacity and to assess the severity and type of impairment of existing as well as undiagnosed conditions.

o The Pulmonary Stress Test will be considered medically necessary for the following conditions:

 To determine whether the patient’s exercise intolerance is related to pulmonary disease, cardiac disease, or due to lack of conditioning or poor effort.

 Initial diagnostic workup when symptoms (generally dyspnea) are out of proportion to findings on static function (spirometry, lung volume, diffusion capacity).

 Detection of interstitial lung disease (fibrosis) or exercise-induced broncho-spasm which are only manifested by exercise.

 Evaluate patient’s response to a newly established pulmonary treatment regimen.

• The majority of clinical problems can be assessed during the simple procedures included in Stage 1, and should be completed before more complex tests are performed.

o Abnormal results indicate that more precise information is required through more complex Stage 2 protocols.

o If Stage 3 protocols are implemented, arterial blood analysis is necessary. In 75% of patients, Stage 1 is sufficient.

o Oxygen titration can be done during graded exercise to determine the oxygen needs for improving exercise tolerance and increased functional capacity.

• Absolute contraindications to exercise testing include:

o Acute febrile illness.

o Pulmonary edema.

o Systolic BP > 250mm Hg.

o Diastolic BP > 120mm Hg.

o Acute asthma attack.

o Unstable angina.

o Acute Myocarditis.

Lung Compliance (94750)

• Lung compliance measures the elastic recoil or stiffness of the lungs.

o It is more invasive than other PFTs, because the patient is required to swallow an esophageal balloon.

• Compliance studies are performed only when all other PFTs give equivocal results, or the results require confirmation by additional data.

 

 

CPT/HCPCS Codes

 

94010 SPIROMETRY, INCLUDING GRAPHIC RECORD, TOTAL AND TIMED VITAL CAPACITY, EXPIRATORY FLOW RATE MEASUREMENT(S), WITH OR WITHOUT MAXIMAL VOLUNTARY VENTILATION

94060 BRONCHODILATION RESPONSIVENESS, SPIROMETRY AS IN 94010, PRE- AND POST-BRONCHODILATOR ADMINISTRATION

94070 BRONCHOSPASM PROVOCATION EVALUATION, MULTIPLE SPIROMETRIC DETERMINATIONS AS IN 94010, WITH ADMINISTERED AGENTS (EG, ANTIGEN[S], COLD AIR, METHACHOLINE)

94200 MAXIMUM BREATHING CAPACITY, MAXIMAL VOLUNTARY VENTILATION

94250 EXPIRED GAS COLLECTION, QUANTITATIVE, SINGLE PROCEDURE (SEPARATE PROCEDURE)

94375 RESPIRATORY FLOW VOLUME LOOP

94620 PULMONARY STRESS TESTING; SIMPLE (EG, 6-MINUTE WALK TEST, PROLONGED EXERCISE TEST FOR BRONCHOSPASM WITH PRE- AND POST-SPIROMETRY AND OXIMETRY)

94621 PULMONARY STRESS TESTING; COMPLEX (INCLUDING MEASUREMENTS OF CO2 PRODUCTION, O2 UPTAKE, AND ELECTROCARDIOGRAPHIC RECORDINGS)

94726 PLETHYSMOGRAPHY FOR DETERMINATION OF LUNG VOLUMES AND, WHEN PERFORMED, AIRWAY RESISTANCE

94727 GAS DILUTION OR WASHOUT FOR DETERMINATION OF LUNG VOLUMES AND, WHEN PERFORMED, DISTRIBUTION OF VENTILATION AND CLOSING VOLUMES

94728 AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY

94729 DIFFUSING CAPACITY (EG, CARBON MONOXIDE, MEMBRANE) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)

94750 PULMONARY COMPLIANCE STUDY (EG, PLETHYSMOGRAPHY, VOLUME AND PRESSURE MEASUREMENTS)

 

 

ICD-9 Codes that Support Medical Necessity

 

135 SARCOIDOSIS

162.0 MALIGNANT NEOPLASM OF TRACHEA

162.2 MALIGNANT NEOPLASM OF MAIN BRONCHUS

162.3 MALIGNANT NEOPLASM OF UPPER LOBE BRONCHUS OR LUNG

162.4 MALIGNANT NEOPLASM OF MIDDLE LOBE BRONCHUS OR LUNG

162.5 MALIGNANT NEOPLASM OF LOWER LOBE BRONCHUS OR LUNG

162.8 MALIGNANT NEOPLASM OF OTHER PARTS OF BRONCHUS OR LUNG

162.9 MALIGNANT NEOPLASM OF BRONCHUS AND LUNG UNSPECIFIED

197.0 SECONDARY MALIGNANT NEOPLASM OF LUNG

197.3 SECONDARY MALIGNANT NEOPLASM OF OTHER RESPIRATORY ORGANS

212.2 BENIGN NEOPLASM OF TRACHEA

212.3 BENIGN NEOPLASM OF BRONCHUS AND LUNG

231.2 CARCINOMA IN SITU OF BRONCHUS AND LUNG

277.02 CYSTIC FIBROSIS WITH PULMONARY MANIFESTATIONS

415.0 ACUTE COR PULMONALE

415.11 IATROGENIC PULMONARY EMBOLISM AND INFARCTION

415.12 SEPTIC PULMONARY EMBOLISM

415.13 SADDLE EMBOLUS OF PULMONARY ARTERY

415.19 OTHER PULMONARY EMBOLISM AND INFARCTION

446.20 HYPERSENSITIVITY ANGIITIS UNSPECIFIED

466.0 ACUTE BRONCHITIS

466.11 ACUTE BRONCHIOLITIS DUE TO RESPIRATORY SYNCYTIAL VIRUS (RSV)

466.19 ACUTE BRONCIOLITIS DUE TO OTHER INFECTIOUS ORGANISMS

486 PNEUMONIA ORGANISM UNSPECIFIED

490 BRONCHITIS NOT SPECIFIED AS ACUTE OR CHRONIC

491.0 SIMPLE CHRONIC BRONCHITIS

491.1 MUCOPURULENT CHRONIC BRONCHITIS

491.20 OBSTRUCTIVE CHRONIC BRONCHITIS WITHOUT EXACERBATION

491.21 OBSTRUCTIVE CHRONIC BRONCHITIS WITH (ACUTE) EXACERBATION

491.22 OBSTRUCTIVE CHRONIC BRONCHITIS WITH ACUTE BRONCHITIS

491.8 OTHER CHRONIC BRONCHITIS

491.9 UNSPECIFIED CHRONIC BRONCHITIS

492.0 EMPHYSEMATOUS BLEB

492.8 OTHER EMPHYSEMA

493.00 EXTRINSIC ASTHMA UNSPECIFIED

493.01 EXTRINSIC ASTHMA WITH STATUS ASTHMATICUS

493.02 EXTRINSIC ASTHMA WITH (ACUTE) EXACERBATION

493.10 INTRINSIC ASTHMA UNSPECIFIED

493.11 INTRINSIC ASTHMA WITH STATUS ASTHMATICUS

493.12 INTRINSIC ASTHMA WITH (ACUTE) EXACERBATION

493.20 CHRONIC OBSTRUCTIVE ASTHMA UNSPECIFIED

493.21 CHRONIC OBSTRUCTIVE ASTHMA WITH STATUS ASTHMATICUS

493.22 CHRONIC OBSTRUCTIVE ASTHMA WITH (ACUTE) EXACERBATION

493.81 EXERCISE-INDUCED BRONCHOSPASM

493.82 COUGH VARIANT ASTHMA

493.90 ASTHMA UNSPECIFIED

493.91 ASTHMA UNSPECIFIED TYPE WITH STATUS ASTHMATICUS

493.92 ASTHMA UNSPECIFIED WITH (ACUTE) EXACERBATION

494.0 BRONCHIECTASIS WITHOUT ACUTE EXACERBATION

494.1 BRONCHIECTASIS WITH ACUTE EXACERBATION

495.0 FARMERS' LUNG

495.1 BAGASSOSIS

495.2 BIRD-FANCIERS' LUNG

495.3 SUBEROSIS

495.4 MALT WORKERS' LUNG

495.5 MUSHROOM WORKERS' LUNG

495.6 MAPLE BARK-STRIPPERS' LUNG

495.7 'VENTILATION' PNEUMONITIS

495.8 OTHER SPECIFIED ALLERGIC ALVEOLITIS AND PNEUMONITIS

495.9 UNSPECIFIED ALLERGIC ALVEOLITIS AND PNEUMONITIS

496 CHRONIC AIRWAY OBSTRUCTION NOT ELSEWHERE CLASSIFIED

500 COAL WORKERS' PNEUMOCONIOSIS

501 ASBESTOSIS

502 PNEUMOCONIOSIS DUE TO OTHER SILICA OR SILICATES

503 PNEUMOCONIOSIS DUE TO OTHER INORGANIC DUST

504 PNEUMONOPATHY DUE TO INHALATION OF OTHER DUST

505 PNEUMOCONIOSIS UNSPECIFIED

506.4 CHRONIC RESPIRATORY CONDITIONS DUE TO FUMES AND VAPORS

506.9 UNSPECIFIED RESPIRATORY CONDITIONS DUE TO FUMES AND VAPORS

508.0 ACUTE PULMONARY MANIFESTATIONS DUE TO RADIATION

508.1 CHRONIC AND OTHER PULMONARY MANIFESTATIONS DUE TO RADIATION

508.2 RESPIRATORY CONDITIONS DUE TO SMOKE INHALATION

508.8 RESPIRATORY CONDITIONS DUE TO OTHER SPECIFIED EXTERNAL AGENTS

508.9 RESPIRATORY CONDITIONS DUE TO UNSPECIFIED EXTERNAL AGENT

515 POSTINFLAMMATORY PULMONARY FIBROSIS

516.0 PULMONARY ALVEOLAR PROTEINOSIS

516.1 IDIOPATHIC PULMONARY HEMOSIDEROSIS

516.2 PULMONARY ALVEOLAR MICROLITHIASIS

516.30 IDIOPATHIC INTERSTITIAL PNEUMONIA, NOT OTHERWISE SPECIFIED

516.31 IDIOPATHIC PULMONARY FIBROSIS

516.32 IDIOPATHIC NON-SPECIFIC INTERSTITIAL PNEUMONITIS

516.33 ACUTE INTERSTITIAL PNEUMONITIS

516.34 RESPIRATORY BRONCHIOLITIS INTERSTITIAL LUNG DISEASE

516.35 IDIOPATHIC LYMPHOID INTERSTITIAL PNEUMONIA

516.36 CRYPTOGENIC ORGANIZING PNEUMONIA

516.37 DESQUAMATIVE INTERSTITIAL PNEUMONIA

516.4 LYMPHANGIOLEIOMYOMATOSIS

516.5 ADULT PULMONARY LANGERHANS CELL HISTIOCYTOSIS

516.8 OTHER SPECIFIED ALVEOLAR AND PARIETOALVEOLAR PNEUMONOPATHIES

516.9 UNSPECIFIED ALVEOLAR AND PARIETOALVEOLAR PNEUMONOPATHY

517.1 RHEUMATIC PNEUMONIA

517.2 LUNG INVOLVEMENT IN SYSTEMIC SCLEROSIS

517.3 ACUTE CHEST SYNDROME

517.8 LUNG INVOLVEMENT IN OTHER DISEASES CLASSIFIED ELSEWHERE

518.0 PULMONARY COLLAPSE

518.1 INTERSTITIAL EMPHYSEMA

518.2 COMPENSATORY EMPHYSEMA

518.3 PULMONARY EOSINOPHILIA

518.4 ACUTE EDEMA OF LUNG UNSPECIFIED

518.51 ACUTE RESPIRATORY FAILURE FOLLOWING TRAUMA AND SURGERY

518.52 OTHER PULMONARY INSUFFICIENCY, NOT ELSEWHERE CLASSIFIED, FOLLOWING TRAUMA AND SURGERY

518.53 ACUTE AND CHRONIC RESPIRATORY FAILURE FOLLOWING TRAUMA AND SURGERY

518.6 ALLERGIC BRONCHOPULMONARY ASPERGILLIOSIS

518.7 TRANSFUSION RELATED ACUTE LUNG INJURY (TRALI)

518.81 ACUTE RESPIRATORY FAILURE

518.82 OTHER PULMONARY INSUFFICIENCY NOT ELSEWHERE CLASSIFIED

518.83 CHRONIC RESPIRATORY FAILURE

518.84 ACUTE AND CHRONIC RESPIRATORY FAILURE

518.89 OTHER DISEASES OF LUNG NOT ELSEWHERE CLASSIFIED

519.11 ACUTE BRONCHOSPASM

519.19 OTHER DISEASES OF TRACHEA AND BRONCHUS

519.4 DISORDERS OF DIAPHRAGM

519.8 OTHER DISEASES OF RESPIRATORY SYSTEM NOT ELSEWHERE CLASSIFIED

780.51 INSOMNIA WITH SLEEP APNEA, UNSPECIFIED

780.53 HYPERSOMNIA WITH SLEEP APNEA, UNSPECIFIED

780.57 UNSPECIFIED SLEEP APNEA

786.02 ORTHOPNEA

786.03 APNEA

786.04 CHEYNE-STOKES RESPIRATION

786.05 SHORTNESS OF BREATH

786.06 TACHYPNEA

786.07 WHEEZING

786.09 RESPIRATORY ABNORMALITY OTHER

786.2 COUGH

786.30 HEMOPTYSIS, UNSPECIFIED

786.39 OTHER HEMOPTYSIS

793.11 SOLITARY PULMONARY NODULE

793.19 OTHER NONSPECIFIC ABNORMAL FINDING OF LUNG FIELD

799.1 RESPIRATORY ARREST

V58.83 ENCOUNTER FOR THERAPEUTIC DRUG MONITORING

V72.82 PRE-OPERATIVE RESPIRATORY EXAMINATION

 

 

Documentation Requirements

 

• Medical record documentation must indicate the medical necessity for performing the test.

o In addition, documentation that the service was performed, including the results of the pulmonary diagnostic tests, should be available.

o This information is normally found in the office notes, progress notes, history and physical, and/or hard copy of the test results.

• If the provider of the service is other than the ordering/referring physician, the provider of the service must maintain hard copy documentation of test results and interpretation, along with copies of the ordering/referring physician’s order for the studies.

o The physician must state the clinical indication/medical necessity for the study in his order for the test.

• Test results and interpretation must be correlated with the clinical presentation of the patient and documented in the medical records.

o The specific procedures performed must be used for decision making and not duplicative of information obtained.

o Therefore, documentation should support that the test results and interpretation were used for the treatment of a specific medical problem by the physician who ordered the services.

Utilization Guidelines

• The frequency of testing (repeat testing) must be related to the patient’s clinical status and correlated to the severity of a specific diagnosis.

Sources of Information and Basis for Decision

 

FCSO LCD FCSO 29265, Pulmonary Diagnostic Services, 01/01/2012. The official local coverage determination (LCD) is the version on the Medicare coverage database at www.cms.gov/medicare-coverage-database/.

 

Medical Encyclopedia: Pulmonary function tests. Retrieved 10/13/2003 from http://www.nlm.nih.gov/medlineplus/print/ency/article/003853.htm

 

Medicare Coverage Database

 

Murray and Nadel. (2000). Textbook of Respiratory Medicine (3rd ed.). W.B. Saunders Company.

 

 

AMA CPT / ADA CDT Copyright Statement

 

CPT codes, descriptions and other data only are copyright 2011 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. © 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.

 

CMS LCD PULMONARY DIAGNOSTIC SERVICES