Wiki Nebulizer treatment

[dlk]

Wonder if anyone knows if a Nebulizer treatment administered in the physicians office (94640) can be billed with a drug code - Albuterol (J7602)?
Thanks for your input.

 

[dballard2004]

Here is my two cents (and I'm sure someone will disagree with what I say), but code 94640 does not include the supply of the medication administered. The supply of the medication may be separatley reported with CPT code 99070 or HCPCS Level II codes, as appropriate.

 

[mkj2486]

We bill the J-codes with 94640, but you have to watch your payors. Medicare and Medicaid will not reimburse for certain J-codes so you cannot always bill for the med. For example J7620 is not on the fee schedule for Medicaid so they will reject it as non-covered. Of course, this may depend on what state your in. I can't remember Medicare's rules off-hand.

We have not had problems with other payers reimbursing for the J-codes.

 

[pammalou]

recently BCBS has started rejecting albuterol as well...

 

[dlk]

This really helps! Thanks so much.

 

[DLGSMITH]

I was following the conversation for this and was wondering what is the difference between concentrated form and unit dose for albuterol?

 

[samorn]

medication

Q: Opinion; would you also bill the J code for medication that is also given, such as prednisolone? If the prednisolone is given before the breathing treatment.

Thank you

 

[HBULLOCK]

Medication

We also bill for the prednisolone. We bill for the albuterol, atrovent, xopenex, whichever we are using on the patient. Not every insurance will pay but we still bill because we have to pay for them.

 

[samorn]

Thank you!!!