Revenue Cycle Insider

Question: Encounter notes indicate that the emergency department (ED) physician performed therapeutic nonpressurized inhalation treatment for a patient with simple chronic bronchitis. Before and after the treatment, the physician performed spirometry to test bronchodilation responsiveness. How should I code this encounter?

AAPC Forum Participant

Answer: On your claim, you should report the following:

• 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) for the nebulizer treatment
• J41.0 (Simple chronic bronchitis) appended to 94640 to represent the patient’s bronchitis

You may be wondering why there is no spirometry code. In your scenario, you would not be able to report 94060 (Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration), as the work is bundled into 94640. You also cannot report 94070 (Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)) with 94640.

Chris Boucher, MS, CPC, Senior Development Editor, AAPC