Pulmonology Coding Alert

Question: Our provider gave inhalation treatment to a patient with acute airway obstruction. The patient was anxious, and almost had to discontinue the treatment. After resting for a while, the patient became comfortable and was given the inhalation treatment again. Can we bill for two separate treatments?

North Carolina Subscriber

Answer: You may report 94640 (Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing [IPPB] device). However, since the above case scenario amounts to a single patient encounter, you may be able to bill code 94640 only once.

According to the 2016 AARC revised coding guidelines for certain respiratory care services, “CPT^® code 94640 should only be reported once during a single patient encounter, regardless of the number of separate inhalation treatments that are administered at that time. However, if there are multiple separate patient encounters for inhalation therapy on the same date of service, the additional encounters of inhalation therapy may be reported with modifier 76 (Repeat procedure by same physician).