Pulmonology Coding Alert

Question: How does one bill for teaching the patient how to use a flow operated inhaled device such as flutter valve? Can it be billed as a separate service?

Maine Subscriber

Answer: You may use CPT^® code 94664 (Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device). This is appropriate for your service, and includes both demonstration of the device operation technique as well as assessing how well the patient is able to use the inhaler device, such as a flutter valve. Remember to use this code only once a day.

Plus: Never try to bill 94664 on the same visit as 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). In rare situations, you may get to bill these on the same day, but even then, the patient must make two distinct, separate visits and you must have stellar documentation to support reporting both codes.