Allergy Coding Alert
Reader Questions: Report Multiple Nebulizer Treatments Per Unit
Question: We often perform numerous nebulizer treatments on a patient on the same day. How should we code to reflect that?
North Carolina Subscriber
Answer: You should bill for nebulizer treatments by the unit. Report 94640 (Pressurized or nonpressurized inhalation treatment for acute airway obstruction ...) for each treatment and append modifier -76 (Repeat procedure by same physician) to subsequent treatments. Some experts also recommend reporting the self-care/home management training code 97535 for time spent teaching.
Code 94664 (Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device) is for teaching a parent or child how to use the nebulizer when a treatment is provided. Some physicians recommend using 94664 for the first treatment and 94640 for subsequent treatments, while others recommend billing 94640 instead because a nurse usually provides the education. CPT does not bundle these codes. Check with carriers for specific guidelines for reporting these codes.
North Carolina Subscriber
Answer: You should bill for nebulizer treatments by the unit. Report 94640 (Pressurized or nonpressurized inhalation treatment for acute airway obstruction ...) for each treatment and append modifier -76 (Repeat procedure by same physician) to subsequent treatments. Some experts also recommend reporting the self-care/home management training code 97535 for time spent teaching.
Code 94664 (Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device) is for teaching a parent or child how to use the nebulizer when a treatment is provided. Some physicians recommend using 94664 for the first treatment and 94640 for subsequent treatments, while others recommend billing 94640 instead because a nurse usually provides the education. CPT does not bundle these codes. Check with carriers for specific guidelines for reporting these codes.
Answers to You Be the Coder and Reader Questions provided by Julie Robertson, CPC, an otolaryngology coding and reimbursement specialist for University ENT Specialists in Cincinnati; Kathy Pride, CPC, CCS-P, HIM, applications specialist with QuadraMed, a national healthcare information technology and consulting firm based in San Rafael, Calif; Tamara Hess, insurance and billing coordinator with an allergy practice in Garland, Texas; and reviewed by Brett Stanaland, MD, FAAAAI, an allergist/immunologist at Naples Community Hospital in Naples, Fla., and assistant clinical professor of medicine at the University of South Florida.
- Published on 2003-07-01
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