Wiki Nebulizer treatments and Peak Flows

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Nebulizer treatments and Peak Flows

A peak flow meter is a plastic, L-shaped tube the patient blows into. Use of a peak flow meter is included in any evaluation and management (E/M) service provided.

• 94010 Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation is for a spirometry, including graphic record

• 94060 Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration is for a spirometry, pre and post nebulizer treatment, and charge nebulizer treatment and solution.

• 94664 Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device is used for the demo of a nebulizer OR a metered dose inhaler.


Best answers
In reviewing our superbills to reflect the 2008 changes in ICD-9 and CPT codes questions have been raised in regards to nebulizer treatments and peak flows. We have been told that peak flows are part of the E/M visit. We have been applying CPT 94010 to this. As for patients who receive a nebulizer treatment during their appt, we have been attaching CPT code 94664 to the service. We have been told that this is incorrect. Would CPT code 94640 be more accurate?
Nebulizer treatment

The correct CPT code for a nebulizer treatment is CPT code 94640.

CPT code 94664 is when you show the patient how to use their inhaler or show the patient how to give themselves a neblizer treatment. This code should not be used as a treatment.
Nebulizer treatments

Thanks Barbara!

I looked through codes in the CPT book and found this code as well. Thanks for confirming.:)
nebulizer treatment

Can you bill for a 94640 (nebulizer tx) and and 94060 (spirometry). The cci edits show that you can append modifier 59 to 94640, but I don't think this appropriate. Any help would be appreciated.


We bill for urgent care and patients get nebulizer treatment 94060 with inhaler. I have been told they bundle these services into the em code is this correct? and what modifier do you use?
We code 94060 and the apporpriate J code for albuterol. We append -25 to the e/m and have no problem with getting the nebs paid. Spiro's are inclusive to an e/m.
The original question was in regards to a peak flow meter. (plastic L shaped tube you blow into - thats all there is - not a machine) This is included in an E/M

94010 is for a spirometry, INCLUDING graphic record (a machine)

94060 is for a spirometry, pre and post nebulizer treatment,(also charge nebulizer treatment & solution)

94664 can be used for the demo of a nebulizer OR a metered dose inhaler

Hope this helps clarify whats what
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for us: the peak flow is included in the E/M -
the Spirometry is 94010 and the E/M is appended with modifier .25
the Nebulizer is 94060 and the E/M is appended with modifier .25 - we do not charge the albuterol.
(of course, it's a given - the E/M's get the .25 only if the documentation supports all services) ;)

oops, thanks Lorisvy -got my numbers mixed up - 94010 & 94060 spirometry
and 94640 neb - we still do not code the albuterol with it - I don't have a current HCPC's book here at home but I recall getting some info on albuterol and the codes being deleted --- that info is a work also, I'll have to check it out, I don't remember exactly what it was about.
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Check your codes, 94060 is for spirometry (measure of lung volume)
while 94640 is for a nebulizer (aerosol inhalation treatment) You can charge the Albuterol. We use J7602 for regular insurance, and J7613 for Medicare (their requested code)
Billing for Nebulizer and Spirometry

Hi. I was told recently that I have to bill 94060 and A7003 for Spirometry and Nebulizer treatments when done in the office w/mod 25 on the E&M, plus J7620 for the albuterol. Please let me know if this correct. Previously I always coded them as 94060, 94640-59 and J7620 w/mod 25 on the visit. Any help would be appreciated. Thanks.

:confused: in the Valley of the Sun.