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Nebulizer treatments and Peak Flows

  1. Default Nebulizer treatments and Peak Flows
    Medical Coding Books
    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?

  2. Default 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.

  3. Default Nebulizer treatments
    Thanks Barbara!

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

  4. Default 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.


  5. #5
    Pueblo, Co
    Default nebulizer
    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?

  6. #6
    Greeley, Colorado
    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.

  7. #7
    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
    Last edited by Lorisvg; 07-26-2008 at 10:45 AM. Reason: added comment

  8. #8
    Duluth, Minnesota
    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.
    Last edited by dmaec; 07-29-2008 at 06:40 PM.
    Donna, CPC, CPC-H

  9. #9
    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)

  10. Cool Nebulizer
    Can you bill 99284-25 with 94640? I would think not.

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