coding office visit and spirometry on the same day

What is the correct coding for billing 99214 and 94010 on the same day? Used a 25 modifier on the office visit, but am starting to receive denials for medical necessity. I understand that this is newly bundled. What would support medical necessity for a pulmonologist to do a spirometry in the office the same day as an office visit?

re: coding office visit and spirometry on the same day

That's a tough question to answer. The same DX on the spirometry and the E/M is always going to boost your chance of a medical necessity denial because the question will be, what are you doing on the E/M that is significant and separately identifiable. If the patient is being seen over shortness of breath or asthma or some other breathing difficulty, and you decide to do spirometry and log a result and take action, what's separately identifiable?