Medicare Benefits Schedule - Item 11507

Measurement of spirometry:

(a) that includes continuous measurement of the relationship between flow and volume during expiration or during expiration and inspiration, performed before and after inhalation of a bronchodilator; and

(b) fractional exhaled nitric oxide (FeNO) concentration in exhaled breath;

if:

(c) the measurement is performed:

(i) under the supervision of a specialist or consultant physician; and

(ii) with continuous attendance by a respiratory scientist; and

(iii) in a respiratory laboratory equipped to perform complex lung function tests; and

(d) a permanently recorded tracing and written report is provided; and

(e) 3 or more spirometry recordings are performed unless difficult to achieve for clinical reasons;

each occasion at which one or more such tests are performed

Not applicable to a service associated with a service to which item 11503 or 11512 applies

Fee: $114.15 Benefit: 75% = $85.65 85% = $97.05

(See para DN.1.21 of explanatory notes to this Category)

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Services billed to item 11507 should meet the following quality standards: 

• An Official ATS Clinical Practice Guideline: Interpretation of Exhaled Nitric Oxide Levels (FENO) for Clinical Applications: Am J Respir Crit Care Med Vol 184. pp 602–615, 2011 DOI: 10.1164/rccm.912011ST.
• ATS/ERS Recommendations for Standardized Procedures for the Online and Offline Measurement of Exhaled Lower Respiratory Nitric Oxide and Nasal Nitric Oxide, 2005: Am J Respir Crit Care Med Vol 171. pp 912–930, 2005 DOI: 10.1164/rccm.200406-710ST

Fewer than three traces will be accepted as billable under item 11507 if three reproducible loops are difficult to achieve for clinical reasons. The clinical reason(s) for not achieving three reproducible loops must be documented.

Services billed to item 11508 should meet the following quality standards:  

• Radtke T, Crook S, Kaltsakas G, et al. ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases. Eur Respir Rev 2019; 28: 180101 [https://doi.org/ 10.1183/16000617.0101-2018]
• Hallstrand TS, Leuppi JD, Joos G, et al. ERS technical standard on bronchial challenge testing: pathophysiology and methodology of indirect airway challenge testing. Eur Respir J 2018; 52: 1801033 [https://doi.org/10.1183/13993003.01033-2018]

For perioperative indications, the test should be conducted according to international guidelines: Perioperative cardiopulmonary exercise testing (CPET): consensus clinical guidelines on indications, organization, conduct, and physiological interpretation for the purpose of preoperative assessment and optimisation for major surgery (published by the Perioperative Exercise and Training Society [POETTS]; British Journal of Anaesthesia, 2018). 

Specialists and consultant physicians providing services under item 11508 should successfully complete a substantial course of study and training in cardiopulmonary exercise testing, which has been endorsed by a professional medical organisation. Specialists and consultant physicians should keep appropriate records of this training.

Related Items: 11507 11508