Otolaryngology Coding Alert

CPT introduces 2 time-based codes with practice expense

When you update your encounter sheet for 2007, make sure to add two new continuous bronchodilator codes.

The new codes, which can be used in hospital respiratory care departments, -will benefit the pulmonary community,- says Alan Plummer, MD, professor of medicine, Division of Pulmonary, Allergy, and Critical Care at Emory University School of Medicine in Atlanta. -The modality has been proven to be effective and safe for patients.-

The basics: -The continuous bronchodilator codes have no physician work, but do have practice expense,- Plummer say. Because no codes existed for continuous bronchodilator administration, the American Thoracic Society (ATS) and the American College of Chest Physicians (ACCP) petitioned CPT for these codes.

Pitfall: As great as the new codes are, their benefits may not be as clear-cut. -Continuous inhalation requires additional time and effort that may not be feasible in the outpatient setting,- says Carol Pohlig, BSN, RN, CPC, ASC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia. The service will not be reported when performed in a hospital setting.

1. Code Based on Total Time

You should assign these codes based on the total treatment time, so chart notes that clearly indicate treatment time are crucial.

Do this: For the first hour of treatment, report 94644 (Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour). Then report  each additional hour with +94645 (- each additional hour [list separately in addition to code for primary procedure]).

2. Use 94645 With 94644

To avoid denials, never report 94645 as the only continuous inhalation treatment code. Code 94645 is an add-on code that you must -use in conjunction with 94644,- states the parenthetical directive following 94645.