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Pulmonology Coding Alert

Reader Question:

Peak Flow Meter

Published on Sun Jul 01, 2001

Question: What is the HCPCS code for a peak flow meter? What is the proper way to bill a nebulizer treatment? Can the medication and supplies be billed separately?

Pennsylvania Subscriber
 
Answer: The peak expiratory flow rate meter, hand held, should be coded as A4614. The nebulizer treatment should be coded as 94640 (nonpressurized inhalation treatment for acute airway obstruction). 
 
According to the Medicare Carriers Manual, Section 2100.5, "Reimbursement may be made for the replacement of essential accessories such as hoses, tubing, mouth pieces, etc., for necessary DME (durable medical equipment) only if the beneficiary owns or is purchasing the equipment." Therefore, it is not reported by the physician's office. For the administration of an inhalant to treat an acute obstruction, use 94640. 

The medication can be billed separately if the physician/physician group covered the expense of obtaining it. For example, albuterol, which may or may not be the only medication used, would be coded, depending on whether it is concentrated (J7618), per one milligram, or a unit dose form (J7619), per one milligram.
 
-- Answers to "You Be the Coder," and Reader Questions provided by: Carol Shea, CPC, Department of Pulmonary Care and Critical Medicine, Lakewood, Ohio; and  Melissa R. Kersnick, CPC, Louisville Pulmonary Associates, Prospect, Ky.

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