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Methacholine Challenge Testing^*

Identifying Its Diagnostic Role, Testing, Coding, and Reimbursement

^* From the Division of Pulmonary and Critical Care Medicine (Dr. Barreiro), Northeastern Ohio Universities College of Medicine, Ohio University College of Osteopathic Medicine, St. Elizabeth Health Center, Youngstown, OH; and Medical Practice Management (Mr. Birnbaum), Hilton Head Island, SC.

Correspondence to: Sam Birnbaum, BBA, CMPE, 4 Coquina Rd, Hilton Head Island, SC 29928; e-mail: sam{at}mypracticeconsultant.com

Abstract

Methacholine challenge testing (MCT), also sometimes described as bronchoprovocation testing, is widely performed for both research and diagnostic purposes. MCT is clinically useful when the patient presents with a history of symptoms suggesting asthma, but spirometry findings are normal. Typically, MCT is performed in a pulmonary function laboratory, a clinic, or a physician’s office. MCT requires time, effort, and understanding. Two standard testing regimes are identified along with proper coding and reimbursement methodologies.

Key Words: asthma • coding • practice management • private practice • pulmonary function test • reimbursement