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Pulmonology Coding Alert

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94640 Goes With Intent To Treat Obstruction

Published on Fri Jan 28, 2011

Question: An established patient with emphysema presents the office complaining of shortness of breath. The pulmonologist provides inhalation treatment, and simultaneously trains the patient on using the nebulizer at home, and provides an expanded problem-focused examination and medical decisionmaking of low complexity. What code should we report?Answer: You should consider two CPTs to report this service. First, you would bill 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]) to cover the comprehensive service the physician provided.Why: 94640 is your best bet since the physician's primary intent was to treat the obstruction. Reporting 94664 (Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device) would risk you a denial.For the office visit, you should report 99213 (Office or other [...]
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