Results 1 to 2 of 2

94640 & E/M code

  1. Default 94640 & E/M code
    Medical Coding Books
    When we give a neb, we typically bill an E/M code (99212-99214) plus the 94640. I noticed that one of our payors is bundling the two codes together but really are only paying the neb. This payor said we should be using the a modifier. Should we use a 25 modifier on the E/M or just bill the 94640 by itself? Does anyone have this problem? We use samples of albuterol so we don't not bill for that.

  2. #2
    You should bill for both the E/M + modifier-25 and the neb treatment. Don't forget supplies (such as A7003/A7015). We also often use drug samples for treatment, but if our drug supply is used, we bill the J-code for the drug.


Similar Threads

  1. E/M with 94640
    By sluke9 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 03-11-2015, 08:49 AM
  2. J code denials:modifier 59 on 94640?
    By Pillow1 in forum Medical Coding General Discussion
    Replies: 7
    Last Post: 12-24-2013, 08:09 AM
  3. 25 Modifier on E&M with 94640, 94760 or 94200?
    By ewilson1 in forum Modifiers
    Replies: 1
    Last Post: 10-31-2011, 10:50 AM

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.