Pulmonology Coding Alert

Question: What is the code for the administration of Heliox therapy to a patient in the ICU? In what specific cases (diagnoses) is the procedure applicable?

Arkansas Subscriber

Answer: You won't find any CPT code for HeO2 therapy. You could report this with an unlisted pulmonary service code (94799, Unlisted pulmonary service or procedure). Make sure your physician writes a detailed report, which you will need when the payer requests more information. Include a procedure description and fee on the claim. Most often, respiratory therapists will deliver this therapy in the hospital after a pulmonologist writes an order to administer it.

Background: Pulmonologists use Helium/oxygen (He/O2) mixtures to help treat severe airflow obstruction seen in patients with acute decompensation of asthma (493.0x, 493.1x, 493.2x, 493.9x), obstructive bronchitis (491.2x) and acute bronchitis (466.0). The He/O2 mixtures are usually 80/20 or 70/30, but could have higher O2 content. The administration, which can be delivered through a special mask to the patient, usually occurs in the ED department or MICU, but could occur on the hospital floor or even in the office. This is a rather rare treatment but is effective and buys time until the bronchodilator therapy and steroids take effect.

ICD-10-CM: The ICD-9 acute bronchitis code (466.0) will be broken down into ten different diagnoses including J20.0 (Acute bronchitis due to Mycoplasma pneumoniae), J20.1 (Acute bronchitis due to Hemophilus influenzae), J20.2 (Acute bronchitis due to streptococcus), J20.3 (Acute bronchitis due to coxsackievirus), J20.4 (Acute bronchitis due to parainfluenza virus), J20.5 (Acute bronchitis due to respiratory syncytial virus), J20.6 (Acute bronchitis due to rhinovirus), J20.7 (Acute bronchitis due to echovirus), J20.8 (Acute bronchitis due to other specified organisms), and J20.9 (Acute bronchitis, unspecified).