CPT 2003:Coders Welcome Revisions to Nebulizer and Allergy Test Codes

If you have ever been confused about coding for nebulizer treatments, your answers are finally here, because CPT has clarified the definition of many allergy codes for 2003.
The newest changes to the CPT nomenclature will go into effect on Jan. 1, 2003. New codes and revisions will affect your billing for nebulizer treatment and allergy testing. Therefore, you need to be clear on the new changes to optimize your reimbursement for the upcoming year.
Clarification Of Nebulizer Treatment Codes
Have you ever found yourself wondering why the clinical aspects of nebulizer treatment are not grouped together under one code, while leaving the evaluation and demonstration techniques for a separate code? Now you have an answer. Beginning in 2003, CPT has revised several inhalation treatment codes to clarify this issue:

94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes (e.g., with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing [IPPB] device), with a cross-reference (For more than one inhalation treatment performed on the same date, append modifier -76)


94664 Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device, with a cross-reference (94664 can be reported one time only per day of service) and (94665 has been deleted).

These changes make logistical sense because now the two more clinical aspects of nebulizer treatments are together and the evaluation and demonstration aspect has its own code.
For example, Anthony Marinelli, MD,FCCP, chairman of the American Thoracic Society's Clinical Practice Committee, describes a 70-year-old with obstructive emphysema (492.8) who is seen for the first time in your office. You decide to prescribe a metered-dose inhaler and instruct the patient on the proper use of the MDI (94664). You have already performed a history, physical exam and medical decision-making. You would bill for theE/M visit with 99241-99245 if the visit is for a consultation or 99201-99205 if the E/M is a new patient visit. Be sure to append modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service)to the office visit code and report 94664 separately.
Allergy Testing Revision
Code 95027 (Skin end point titration) has a new definition that adds more specificity to clarify the code's usage. The revised code reads, "Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, specify number of tests." The definition of the code was changed to make it more consistent with other allergy [...]

- Published on 2002-12-01