The situation when the procedure is warranted
The pulmonary function test is recommended when a patient shows certain symptoms. These symptoms include but are not limited to persistent cough, tightness, pressure and pain in the chest region, wheezing, difficulty in breathing, and dyspnea. The main aim of requesting or performing such procedures will be two(Langan & Goodbred, 2020). One is to determine the condition of the lungs, that is, how the chest muscles and lung tissues expand and contract. This enables doctors to determine the volume of air the lungs can accommodate at a particular time and can help in understanding the symptoms experienced by patients. The second aim revolves around analyzing the airways, that is, the functioning of the trachea, bronchus, and pharynx, to understand the airflow in and out of the lungs.
Age-related considerations for the procedure
There are often challenges associated with age and conducting diagnostic tests such as pulmonary function tests. This is because there are age considerations when performing such tests. For instance, it is recommended that the pulmonary function test be conducted in children aged 8 years and above. This is because it becomes difficult to obtain accurate results for children below the age of 8 years because of issues revolving around the consistency and rigour of the results (Wan et al.,2021). Therefore, for children below the age of 8 years, it is recommended that experienced healthcare officials perform the test and that expert opinion be obtained to establish rigour in the results.
Methods for completing the procedure
There are two major methods used in completing the tests. One of these methods is the use of Spirometry. Spirometry involves using a spirometer; a spirometer can be described as an apparatus consisting of a mouthpiece fixed onto a machine. The spirometer measures restrictive and obstructive ventilation patterns (Paynter et al.,2022). The other method is often referred to as Plethysmography. This apparatus also requires the patient to stand or sit in an airtight box for the text to be completed. The Plethsymograph measures the volume of air the patient’s lungs can hold.
Expected outcome and follow-up required
Various expected outcomes arise from the diagnostic test. For instance, the test measures the tidal volume. That is the amount of air the patient inhales and exhales under normal respiratory circumstances. The air volume will be compared to specific reference values; in this case, the volume will be compared to the recommended 7ml per kg (Wan et al.,2021). The results will inform the next procedure, which can revolve around more diagnostic tests like chest X-rays. Radiological images can help in differential diagnosis. Patients are given medications to increase or reduce tidal volume in less severe cases.
Billing and coding considerations
One of the billing considerations is contained in section 42 of the code of federal regulation. Code 410.32 highlights that patients should be billed when the diagnostic test is conducted by the healthcare practitioner treating the patient who benefits from the test. The results have to be used in the treatment processes. The billing process is unique to each practitioner because of differential factors unique to each healthcare facility. The coding of the pulmonary functioning test depends on the method used to conduct the test. For instance, the CPT codes for using Spirometry are 94375,94150,94726 and 94200 (Langan & Goodbred, 2020). The main aim is to avoid repetitive billing.
Appropriate clinical practice guidelines
One of the guidelines of the test revolves around the billing process. That is, billing should not be processed when proper documentation is absent. Healthcare professionals conducting the test and interpreting the results need to have proper knowledge of the standard reference values of the measures (Graham et al.,2019). The main aim is to avoid the wrong diagnosis. Healthcare officials also need to identify rigour in performing the test by identifying wrong procedures and standard spirometry measures. According to the care quality Commission standards, for healthcare officials to achieve this, they need adequate training to perform the tests and interpret the results.
References
Graham, B. L., Steenbruggen, I., Miller, M. R., Barjaktarevic, I. Z., Cooper, B. G., Hall, G. L., … & Thompson, B. R. (2019). Standardization of spirometry 2019 update. An official American thoracic society and European respiratory society technical statement. American Journal of Respiratory and critical care medicine, 200(8), e70-e88.
Langan, R. C., & Goodbred, A. J. (2020). Office spirometry: indications and interpretation. American family physician, 101(6), 362-368.
Paynter, A., Khan, U., Heltshe, S. L., Goss, C. H., Lechtzin, N., & Hamblett, N. M. (2022). A comparison of the clinic and home spirometry as longitudinal outcomes in cystic fibrosis. Journal of Cystic Fibrosis, 21(1), 78-83.
Wan, E. S., Balte, P., Schwartz, J. E., Bhatt, S. P., Cassano, P. A., Couper, D., … & Oelsner, E. C. (2021). Association between preserved ratio impaired Spirometry and clinical outcomes in US adults. Jama, 326(22), 2287-2298.
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