Q What codes should I submit if, during a problem-oriented office visit, I decide the patient requires a nebulizer treatment and the nurse gives the patient instructions on using a nebulizer or metered dose inhaler at home?
A You should submit the appropriate evaluation and management (E/M) office visit code, the code for the nebulizer treatment (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)"), the code for the nurse's instructions (94664, "Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device") and the correct J code for the supply of the nebulizer drug. You should also add modifier -25 to the E/M code to indicate that it was a significant, separately identifiable service from the other services described.
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