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Help with coding nebulizer treatment

  1. Default Help with coding nebulizer treatment
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    Does anyone know if the modifier 25 needs to be appended to code 94640 (nebulizer treatment), for acute asthma with cpt code 99214.

  2. #2
    Greeley, Colorado
    Mod -25 goes on 99214.
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Don't forget to charge/code the med that you use in the nebulizer...
    Yolanda T. Haskins CPC, CRC, OHCC, AAPC Fellow
    Past AAPCCA Board of Directors 2014 - 2017

    Alexandria, VA Chapter

    ~ Practice Kindness ~

  4. #4
    Is there a way to charge if more than one treatment was done? And also, I was told before that you could not charge for the medicine that was given in nebulizer...

    I work at a pediatric office so we do lots of nebulizer treatments. Majority of our patients have Medicaid. Can someone please tell me how to bill?

  5. #5
    Columbia, MO
    You charge the visit level, in your example the 99214 with the 25 modifier
    you charge the neb 94640
    the 2nd neb 94640 76
    you can charge the medication, however most if not all carriers will bundle the medication with the neb.
    given the documentation you might be abl;e to append prolonged time as well. If the physician will document his total face to face time with the patient, ( some carriers want this as time in and time out documented) then you might have enough.
    for example most of the ones I have done the physician will document 45 minutes with the patient, that is the threshold time needed for the 99354 with a 99213 and most I have read are a 99213.
    so if you gave 2 nebs and have good documentation including the time then:
    99213 25
    94640 76

    Debra A. Mitchell, MSPH, CPC-H

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