Delivery/Birthing – Claim Documentation Requirements

CodeCode DescriptionDocumentation Required
94011Measurement of spirometric forced expiratory flows, in an infant or child through 2 years of ageClinical notes
94012Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of ageClinical notes
94013Measurement of lung volumes (i.e., functional residual capacity (FRC), forced vital capacity (FVC), and expiratory reserve volume (ERV)) in an infant or child through 2 years of ageClinical notes

In addition, HMSA may require submission of clinical records before or after payment of claims for the purpose of investigating potential fraudulent, abusive or other inappropriate billing practices, but only as long as there is a reasonable basis for believing such investigation is warranted.


Revision History

Date Nature of Revision
08/03/2026 Migrated to new platform.