Wiki Asthma Inhalers

[gcohen]

Has any had success in reimbursement for billing inhalers, ie, albuterol, from the pcp office?

 

[rthomas@impcna.com]

Has any had success in reimbursement for billing inhalers, ie, albuterol, from the pcp office?

We have had success with billing for teaching a patient how to use an inhaler (94664) and billing for nebulizer treatments (94640)done in the office.

 

[gcohen]

We have had success with billing for teaching a patient how to use an inhaler (94664) and billing for nebulizer treatments (94640)done in the office.

Same here, but we want to bill the inhaler only without the neb treatment.

 

[rthomas@impcna.com]

Same here, but we want to bill the inhaler only without the neb treatment.

When you say inhaler, are you referring to the mouth piece that goes on a nebulizer or and actual rescue inhaler that patient needs an rx for?

 

[SharonCollachi]

Why are you not just giving them a prescription?

 

[gcohen]

When you say inhaler, are you referring to the mouth piece that goes on a nebulizer or and actual rescue inhaler that patient needs an rx for?

Both, to dispense both.

 

[gcohen]

Why are you not just giving them a prescription?

looking into if cost effective

 

[SharonCollachi]

looking into if cost effective

I don't think it's ever going to be cost-effective to insert yourself into the patient's pharmacy benefits.

 

[DeBillingTater]

You can go about it one of two ways:
1. Issue prescription for patient to pick-up at pharmacy.
2. If you have a small medication outlet within your practice, offer inhalers as self-pay only. Insurance won't reimburse unless you have a full-time pharmacists dispensing medications at your practice.

Nebulizer piece is billable as a supply so you can offer those in-office. Just include the NU modifier with it and verify that your reimbursement rates are equal or higher than your supplier cost?

 

[gcohen]

When you say inhaler, are you referring to the mouth piece that goes on a nebulizer or and actual rescue inhaler that patient needs an rx for?

the rescue inhaler and the spacer (holding chamber)

 

[gcohen]

You can go about it one of two ways:
1. Issue prescription for patient to pick-up at pharmacy.
2. If you have a small medication outlet within your practice, offer inhalers as self-pay only. Insurance won't reimburse unless you have a full-time pharmacists dispensing medications at your practice.

Nebulizer piece is billable as a supply so you can offer those in-office. Just include the NU modifier with it and verify that your reimbursement rates are equal or higher than your supplier cost?

thanks so much for the information