Results 1 to 9 of 9

Nebulizer treatment

  1. #1
    Default Nebulizer treatment
    Clearnace Sale
    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.

  2. #2
    Overland Park, KS
    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.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

  3. Default
    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.

  4. #4
    St. Cloud, MN
    recently BCBS has started rejecting albuterol as well...

  5. #5
    This really helps! Thanks so much.

  6. #6
    Charlotte North Carolina Chapter
    I was following the conversation for this and was wondering what is the difference between concentrated form and unit dose for albuterol?

  7. #7
    Default 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

  8. #8
    Thumbs up 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.

  9. #9
    Thank you!!!

Similar Threads

  1. Nebulizer treatment in clinic
    By kimbowen in forum Family Practice
    Replies: 8
    Last Post: 06-19-2018, 11:48 AM
  2. E/M and nebulizer treatment
    By corikr77 in forum Family Practice
    Replies: 3
    Last Post: 05-23-2012, 06:18 PM
  3. Nebulizer Treatment - different drugs
    By kumeena in forum Billing/Reimbursement
    Replies: 0
    Last Post: 02-06-2012, 01:31 PM
  4. Nebulizer Treatment in ER
    By PeaPod1 in forum Emergency Department
    Replies: 3
    Last Post: 06-27-2011, 09:22 PM
  5. Nebulizer Treatment
    By mkimbrell in forum Internal Medicine
    Replies: 1
    Last Post: 04-23-2009, 05:01 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.