Pulmonology Coding Alert

Take a peek at the inhalation solution codes

While you're updating your infusion codes, make sure you remember the four fairly new nebulizer medication codes to make your J code reporting dose-specific.

HCPCS 2005 deletes the codes you previously used to report nebulizer medications: J7618-J7619.

Right way: You should now assign the following dose-specific codes:

 J7611 - Albuterol, inhalation solution, administered through DME, concentrated form, 1 mg

 J7612 - Levalbuterol, inhalation solution, administered through DME, concentrated form, 0.5 mg

 J7613 - Albuterol, inhalation solution, administered through DME, unit dose, 1 mg

 J7614 - Levalbuterol, inhalation solution, administered through DME, unit dose, 0.5 mg. You no longer have to lump Albuterol and Levalbuterol together as in the past with these deleted codes:
 J7618 - Albuterol, all formulations including separated isomers, inhalation solution administered through DME, concentrated form, per 1 mg (Albuterol) or per 0.5 mg (Levalbuterol)

 J7619 - Albuterol, all formulations including separated isomers, inhalation solution administered through DME, unit dose, per 1 mg (Albuterol) or per 0.5 mg (Levalbuterol). Better way: When coding nebulizer medication, you can now locate the right code in two steps:

1. Identify the medication name: albuterol (Ventolin, Proventil) (J7611, J7613) OR levalbuterol (Xopenex) (J7612, J7614).

2. Locate the form: Concentrated (J7611-J7612) OR premixed/unit-dose (J7613-J7614). Remember: You should still report 94664 (Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered-dose inhaler or IPPB device) when the pulmonologist demonstrates and/or evaluates patient utilization of an aerosol generator, nebulizer, metered-dose inhaler or IPPB device, says Alan L. Plummer, MD, professor of medicine, Division of Pulmonary, Allergy and Critical Care at Emory University School of Medicine in Atlanta.

The documentation may include details on the device the physician demonstrated or observed, patient comprehension, accuracy and appropriateness of physician's utilization, educational issues that the physician addressed, and patient response, Plummer says.

Medicare and private payers require that the pulmonologist or nurse (whoever demonstrated the nebulizer or inhaler) sign the documentation.