Author: Practitioners, Facilities and Policy Development
Effective July 1, 2018, CPT Code 95012, Fractional Exhaled Nitric Oxide (FENO) measurement, is approved in the assessment of pediatric beneficiaries with suspicion of asthma and for asthma management. Exhaled nitric oxide measurement is considered medically necessary and is covered when used as an adjunct with spirometry.
FENO measurement is considered medical necessary to:
- Monitor anti-inflammatory response,
- Monitor compliance,
- Detect steroid resistance, and,
- Predict exacerbation of disease.
Medicaid beneficiaries between the ages of 5 and 18 and N.C. Health Choice beneficiaries between the age of 6 and 18 are eligible for this service.
North Carolina Medicaid will cover CPT code 95012 five times per 365 days per billing provider.
Prior approval is not required.