Pulmonology Coding Alert

Question: Can CPT 94664 be charged with an office visit? North Carolina Subscriber Answer: The 2003 National Physician Fee Schedule lists 94664 (Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device) with status code "A." This means that the code can be paid separately in addition to another service, including an office visit.

The question remains regarding whether the physician meets the criteria needed to use modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) with the office visit. In other words, if the physician performs parts of an E/M visit other than simply evaluating the patient's understanding and use of the nebulizer, such as evaluating the patient's asthma, then this would qualify as a separate service. It is useful for you to provide separate diagnosis codes for the E/M and nebulizer treatment, when available.