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Pediatric Coding Alert

Reader Question:

Multiple Nebulizer Training

Published on Fri Mar 01, 2002

Question: We often perform numerous nebulizer treatments on a patient on the same day. How should we code to reflect that?

North Carolina Subscriber  
Answer: Bill for nebulizer treatments by the unit. Bill 94640 (Nonpressurized inhalation treatment for acute airway obstruction) for each treatment, with modifier -76 (Repeat procedure by same physician) appended to subsequent treatments. Some experts also recommend reporting the self-care/home management training code 97535 for time spent teaching.
 
Code 94664 (Aerosol or vapor inhalations for sputum mobilization, bronchodilation, or sputum induction for diagnostic purposes; initial demonstration and/or evaluation) is for teaching a parent or child how to use the nebulizer when a treatment is provided. Some pediatricians recommend using 94664 for the first treatment and 94640 for more treatments. Others say to bill 94640 instead because a nurse usually provides the education. CPT does not bundle these codes.
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