Pediatric Coding Alert

Hint: look to NCCI bundling guidelines for answers.

There’s a lot of room for errors when coding inhalation treatments. That’s because many of the codes in the Pulmonary Diagnostic Testing and Therapies section of CPT^® is subject to stringent guidelines and bundling policies.

So, it’s always a good idea to refresh your understanding of inhalation treatment coding. Answering these three questions about 94640 and its associated codes correctly will help you go a long way toward that goal.

Question 1: Which CPT^® codes cannot be billed with 94640, and why and how do you document the inhalation treatment?

Question 2: Your pediatrician administers two distinct inhalation treatments, each lasting for 55 minutes, to the same patient at different times on the same calendar day. Which of the two inhalation treatment codes — 94640 or 94644 (with or without add-on +94645) — would you use, and how would you code the encounter?

Question 3: Can you bill for a nebulizer demonstration together with 94640 and, if so, what is the correct way to do it?

Think you know the answers?