Pulmonology Coding Alert

Now CMS makes it easier for you to report compound solutions Just when you thought the excitement was over, we have two more J codes to add to your nebulizer repertoire for 2005.
 
In the May issue of Pulmonology Coding Alert, we updated you on the relevant J code deletions and a new two-step process to locate the correct albuterol or levalbuterol codes. (See "Refer to This List to Stay on Top of Your Latest J Codes" on page 35 of the May Pulmonology Coding Alert.) 
 
HCPCS 2005 adds two new compound inhalation solution codes that you may use - even when your office premixes the drugs:
  J7616 - Albuterol, up to 5 mg and ipratropium bromide, up to 1 mg, compounded inhalation solution, administered through DME
    J7617 - Levalbuterol, up to 2.5 mg and ipratropium  bromide, up to 1 mg, compounded inhalation solution, administered through DME.
 
Old way: When a pulmonologist administered a nebulizer treatment containing a compounded inhalation solution of albuterol and levalbuterol, you should have assigned J7621 (Albuterol, all formulations, including separated isomers, up to 5 mg [albuterol] or 2.5 mg [levalbuterol], and ipratropium bromide, up to 1 mg, compounded inhalation solution, administered through DME). HCPCS 2005 deletes this J code.
 
New way: You should now specify whether the pulmonologist uses a compounded inhalation solution of:
  albuterol and ipratropium bromide - J7616 or 
  levalbuterol and ipratropium bromide - J7617. Bill Premixed Solution With Compounded Code Codes J7616 and J7617 may come in handy more than you think. Even if you premix albuterol/levalbuterol and ipratropium bromide, you should still use these new compounded inhalation solution J codes, says Kent J. Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians in Leawood, Kan.
 
Reason: "Medicare implies that premixed and compounded are synonymous," Moore says. In the 2005 fee schedule proposed rule (see page 61 of the document at www.cms.hhs.gov/providers/drugs/mpfs_05pr.pdf) CMS talks about suppliers furnishing albuterol and ipratropium bromide in "a premixed form (either commercially premixed or pharmacy-compounded)."
 
"So if a physician's office (like a pharmacy) mixes the two and administers them, they should use the compounded inhalation solution codes: J7616 or J7617," Moore says.
 
Example: Your practice may mix levalbuterol and ipratropium bromide solutions while another clinic orders premixed albuterol and ipratropium bromide.
 
The clinic that orders premixed solutions should use the compounded codes for either solution (J7616-J7617), instead of the component codes, such as J7613 (Albuterol, inhalation solution, administered through DME, unit dose, 1 mg) and J7644 (Ipratropium bromide, inhalation solution administered through DME, unit dose form, per mg) or J7614 (Levalbuterol, inhalation solution, administered through DME, unit dose, 0.5 mg) and J7644, says Carol Pohlig, BSN,   RN, CPC, senior coding and education specialist at   [...]