Advanced Search

Primary Care Coding Alert

YOU BE THE CODER ~ Multiple Inhalation Claims

Published on Sat Apr 28, 2007

Question: Our physician performed a pair of inhalation treatments on a patient recently. I reported two units of 94640, and the payer denied the second charge as duplicative. Why did I receive a denial?

New Jersey Subscriber

Answer: The insurer issued a denial because you reported the second treatment improperly.

Try this: Instead of using units -for more than one inhalation treatment performed on the same date, append modifier 76- (Repeat procedure by same physician), according to the parenthetical instruction following 94640 (Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes [e.g., with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device]).
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Primary Care Coding Alert

View All