Pulmonology Coding Alert

Your pulmonologist sees Mrs. Jones in the office and gives her a nebulizer treatment in the office and a prescription for a new asthma maintenance inhaler to help her through the exacerbation in respiratory symptoms (wheezing, dyspnea on exertion). The pulmonologist says that if this doesn't help, he'll consider steroid therapy when she returns. Mrs. Jones returns one week later with progressing symptoms. Your physician completes another evaluation prior to administering another nebulizer treatment and establishing a plan for steroid therapy. Report the nebulizer treatment with 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]). Append modifier 25 to the appropriately selected E/M.