Pulmonology Coding Alert

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   the University of Pennsylvania department of medicine in Philadelphia.