# 94640 In-Office Nebulizer Treatments



## Tbeechler (Jul 29, 2011)

We have been seeing denials from insurance companies when we see a patient and bill for an office visit with a nebulizer treatment.  They are denying the office visit and paying only for the nebulizer treatment.  Is anyone else having this issue?  What are you doing/suggestions on what to do to get around it?  Thanks!


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## jackson7591 (Jul 29, 2011)

*additional*

What is the level of office visit you are coding for?  Is the diagnosis consistent with the medical necessity of a nebulizer tx?  Are you using any modifiers?


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## Tbeechler (Jul 29, 2011)

We are using a 99213.  Pt presented with wheezing, coughing, fever, SOB.  The pulse ox warranted, along with presenting problems, the nebulizer treatment.  I didn't use any modifiers as I wasn't sure which one would really apply.  Mod 25 wouldn't work because of the same dx code being used.


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## wkarr (Jul 29, 2011)

*additional*

You can use mod 25. the difinition in the CPT for Modifier 25 states that " a different diagnosis is not required"


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