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Nebulizer treatment in clinic

  1. Default Nebulizer treatment in clinic
    Medical Coding Books
    what is the code that wer can charge for a nebulizer treatment in clinic. Does anyone know if we can charge for the mask set up? what is the HCPCS code for Albuterol 0.083% for each treatment?

    Can someone answer this for me..


    Kim Bowen, CPC

  2. #2
    I can just tell you what we do in our office. We charge 94640 for the nebulizer treatment. We consider the mask set up and albuteral as part of the charge for that treatment so they are not coded seperatly. I would be interested to know what other offices do.

  3. #3
    Default Neb TX
    We code 94640 then code for the peak flow 94150 (if done) and A7016 for the mouthpiece and A7003 for the tubing and then J7612 for xopenex but I heard that was the wrong code for xopenex so that one may not be right. We also include a pulse ox (if done) and that CPT is 94760. Most carriers pay however, we got a stack of denials recently from Healthchoice for the A codes and I am wondering why.

  4. #4
    Default DSHS denial 94760 and 94640
    I recently noticed DSHS denying 94760 and the E/M code when billing the 94640. I can see if need be adding a 25 mod to the E/M if it is a seperate service (even though the CPT book doesn't say you have to) but do you also have to put a 59 mod on the 94760 to show it is a different lab procedure?

  5. #5
    We charge 94640 for the nebulizer treatment, and J7613 for the Albuterol.
    Regarding the denial for 94760 (Oximetry) we have been finding that most insurance companies in our area deny this as incedental to the E/M no matter what modifier is used. We have now stopped charging for it. Regarding the denials on the A codes, these are colored in HCPCS as payable "at carriers discretion". We all know what that means

  6. Default
    We do that samething as LORISVG. We code the 94640 and the J7613 for the albuteral unless its the albuteral and ipratropium bromide then use J7620.
    Stephanie, CPC, HCS-D

  7. Default
    We code 94640 for Neb tx and J7610 for Albuterol or J7615 for Xopenex. The neb tx gets paid but the meds rarely do.

  8. Default Nebulizer Documentation
    Does anyone know exactly what the proper documentation is for a Nebulizer treatment? That would maybe help to ensure that it gets billed?

    Right now we are just putting that a nebulizer treatment was done. Do we need timing? Lot and exp (if they aren't paying for the medicine anyways)? the Code for each piece of equipment used?


  9. Default Albuterol
    We are a Derm office new to Allergy we where told we could not bill the J7620 and A7003 in a office setting. Have any of you also had this issue?

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