Pediatric Coding Alert

Make sure you update Albuterol, Levalbuterol and respiratory syncytial virus (RSV) test codes on your superbill this year or payers will reject these claims.

Use 4 New J Codes for Nebulizer Supplies

  HCPCS Codes 2005 deletes the codes you previously used to report nebulizer medications, J7618-J7619, says Denise Salton, financial counselor at Virginia Beach Pediatrics in Norfolk. You should now assign:
 

J7611 - Albuterol, inhalation solution, administered through DME, concentrated form, 1 mg
 

J7612 - Levalbuterol, inhalation solution, administered through DME, concentrated form, 0.5 mg
 

J7613 - Albuterol, inhalation solution, administered  through DME, unit dose, 1 mg
 

J7614 - Levalbuterol, inhalation solution,  administered through DME, unit dose, 0.5 mg.

Rejoice: The new codes make reporting nebulizer medications easier. You no longer have to lump Albuterol and Levalbuterol together as J7618 (Albuterol, all formulations including separated isomers, inhalation solution administered through DME, concentrated form, per 1 mg [Albuterol] or per 0.5 mg [Levalbuterol]) or J7619 (Albuterol, all formulations including separated isomers, inhalation solution administered through DME, unit dose, per 1 mg [Albuterol] or per 0.5 mg [Levalbuterol]). Using the same codes proved confusing because the doses for each medication are different.
 
Bottom line: When coding nebulizer medication, you can now locate the right code by identifying the medication name - albuterol (Ventolin, Proventil) or levalbuterol (Xopenex) - and form - concentrated versus premixed or unit-dose.

Report Specific RSV Lab Code

In other news, CPT 2005 creates a laboratory code for in-office RSV testing.
 
Old method: You previously had to report the test with unlisted-procedure code 87899-QW (Infectious agent detection by immunoassay with direct optical observation; not otherwise specified; CLIA waived test). But you now have a specific code that describes the procedure.
 
New way: You should use 87807-QW (Infectious agent antigen detection by immunoassay with direct optical observation; respiratory syncytial virus) for RSV Binex NOW, Tina Digman, coder at Woodhill Pediatric Associates in Dallas, tells Pediatric Coding Alert. Digman's representative informed her of the change, which also applies to Integrated Biotechnology's RSV test called Integrated Biotechnology Quick Lab.
 
Note: The January 2005 Pediatric Coding Alert reader question "Nebulizer, Vaccine Codes Include Inherent Supply Costs" and article "Refresh Your Winter-Germ Detection Filing Skills" did not include these new codes.