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Internal Medicine Coding Alert

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Code for Nebulizer Teaching

Published on Mon May 01, 2000

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.


Question: What CPT code is best suited for nebulizer teaching? Previously, we used code 94664, but we have gotten denials saying that it was not a specific-enough code. Last year, we also used 94640.

Texas Subscriber


Answer: Code 94664 (aerosol or vapor inhalations for sputum mobilization, bronchodilation, or sputum induction for diagnostic purposes; initial demonstration and/or evaluation) is the correct code to use, advises Lane Rierson, CPC, of Health Care Consulting in Greensboro, N.C. According to information published in the February 1996 and May 1998 issues of the American Medical Associations CPT Assistant, code 94640 is used to report an inhalation treatment given for an acute airway obstruction, e.g., status asthmaticus. It should not be used to report a demonstration of aerosol or vapor inhalation treatments for educational purposes. Code 94664 should be used for the initial demonstration and/or evaluation of aerosol or vapor inhalations for sputum mobilization, bronchodilation or sputum induction for diagnostic purposes.

This code best describes teaching the patient to use the nebulizer for bronchodilation or sputum mobilization. Many medical practices are reporting that several payers do not cover this code. If it is a significant portion of your practice, you may want to consider negotiating a set amount with your payers for this service, and setting up payer-specific codes to use for reimbursement. But be sure to get such agreements in writing.



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