Pulmonology Coding Alert

Question: Should I use 94664 for education/training with the Advair diskus? Our allergist says "no," but our other physicians say "yes."Wisconsin SubscriberAnswer: Code 94664's descriptor specifies "demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device."Part of teaching the proper technique in using an inhaler -- either propellant-driven (an MDI) or dry powder (Advair Diskus) -- is to demonstrate and evaluate."In this respect, the code would seem appropriate to use for demonstration and evaluation," writes Gary N. Gross, MD, executive vice president of the Joint Council of Allergy, Asthma & Immunology, in an e-mail response. "Unfortunately, not all payers will pay for this code," he adds.If practices abuse 94664, experts predict that fewer payers will pay.To support reporting 94664, include an indication of medical necessity with your documentation (for instance, a notation of why the education training was necessary to teach the patient the proper technique for the new form of medication).