Pulmonology Coding Alert

Question: If a patient comes to the office with an acute exacerbation of asthma and the physician administers nebulizer treatment, can we bill for the equipment we used to provide the treatment (i.e., the mouthpiece, etc.) in addition to the medicine we used (proventil and/or atrovent)?

Maryland Subscriber Answer: You should not bill separately for the mouthpiece or drug costs because payers include these expenses in the payment for 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]). This is the only code you should report for the procedure you describe above.  - Answers for You be the Coder and Reader Questions were reviewed by Carol Pohlig, BSN, RN, CPC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia; and Alan L. Plummer, MD, professor of medicine, Division of Pulmonary, Allergy and Critical Care at Emory University School of Medicine in Atlanta.