Hcpcs j7611-j7614

lisner1204

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I am trying to find out if these J codes can be billed in a physicians setting when we give a nebulizer treatment in the office?

Thank you.
L~
 

nrood

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Hopefully, you received an answer already, but yes, the drug should be billed with the neb treatment. Like an injection- you bill for the drug and administration- you would bill for the use of the machine and also the drug used. Be careful if you use the Duoneb, you can only bill out as a max of 6 units. You can also bill for the demonstration of the nebulizer (or an inhaler), if done, if patient is being sent home with a nebulizer-or a script to purchase a nebulizer. See below- This is what we have given our office staff for reference. (these J codes are the only codes we use based off of the drugs we purchase. You could be using different J codes depending on what you get/give.)

Albuterol treatments
94640
Pressurized or nonpressurized inhalation treatment for acute airway obstruction or sputum induction for diagnostic purposes (eg, with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing [IPPB] device)

J7613 – Albuterol, inhalation solution, FDA-approved final product, noncompounded, administered through DME unit dose, 1mg
(Should report 8 units when entire bottle of concentrate is used)

J7614 - Levalbuterol, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose, 0.5mg (Xopenex)
(0.63mg/3ML – 4 units should be reported when entire bottle of concentrate is given.
1.25mg/3ML – 8 units should be reported when entire bottle of concentrate is given.)

J7620 - Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, FDA-approved final product, noncompounded, administered through DME (Duoneb)
(Should report 6 units when entire bottle of concentrate is used)

If the patient is taking a nebulizer home and is shown how to use the following code should be reported.
94664 -
Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device.
(Append a 59 modifier to this code)

**When a 94010, 94060, or 94640 is billed in conjunction with the 94664, use 59 mod on 94664**

 
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