FENO (Fractional Exhaled Nitric Oxide) testing

The division has purchased a FeNO machine (Niox Vero device) to be used in clinic on K17 in Detroit.  While this equipment will be available for any patient who sees pulmonary medicine in clinic, it will be stored and used in Detroit only.

HOW TO USE THE FeNO MACHINE

The testing for FENO using the Niox Vero device is relatively simple:

  1. Turn on the device
  2. Attach a new mouth filter to the breathing handle (use a new filter for each patient to avoid cross-contamination)
  3. Instruct the patient to fully exhale
  4. Inhale deeply through the mouthpiece
  5. Exhale steadily for 10 seconds while maintaining a tight seal around the mouthpiece
  6. The device will analyze the breath sample and display the FeNO result on the screen

The FeNO value will be given to the provider after it is obtained. 

  • The testing will be completed in clinic by the clinical team (MA’s, nurses).  This test will not be completed by the PFT lab at this time to avoid the logistics of moving patients to/from the lab for testing after they have been roomed in clinic.
  • Providers can learn become “certified” to do this test without involving the clinic team, but there is a process to doing this.  Please find Mike Lazar or Ebony Richardson to discuss further.
  • Finally, please understand that the clinic team will have to prioritize patient throughput vs. performing FENO testing.  There is a possibility that a patient will have to return at a later date to do the FENO test

Here are videos on how our team will perform the FeNO on the device:

BILLING

The CPT code for billing for this procedure in Epic is: 95012

To bill for this testing:

The charge capture code for this is: 924000012

HB NITRIC OXIDE EXP GAS DETERMINATION

Please note: The provider bills for this test (similar to smoking cessation counseling; found in the “Wrap up -> Charge Capture” section) while the clinic team conducts the testing.

Here are some additional resources for FENO:

  • How to order a FENO test
  • A document to help guide on the use of FENO in patients with asthma and cough
  • A review article on FENO in asthma
  • An article about the effects of spirometry on FENO (consideration in patients who have PFTs prior to receiving FENO testing)