Wiki MCR denial of nebulizer (94640) when wheezing is primary DX

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ladybug1972

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We are consistently receiving denials from MCR stating the nebulizer treatment is not covered with the wheezing R06.2 diagnosis. Upon CMS research, wheezing is a diagnosis on the list that can be used for payment. In addition, they are paying only 0.11 towards the albuterol medication. Anyone have any ideas?
 
Wheezing

Do you have any diagnosis? As the wheezing is a symptom of an underlining condition or even an reaction to environmental elements. Does the documentation give you any more?:eek:
 
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