Nebulizer Therapy Billing Reminders - Modifiers, Dispensing Fees, and Orders

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
February 24th, 2016

The ICD-10-CM code describing the condition necessitating nebulizer therapy must be included on each claim for equipment, accessories, and/or drugs.

When ever a unit dose code is billed, it must have a KOKP, or KQ modifier. (Exception: The KOKP, and KQ modifiers should not be used with code J7620.)

When billing miscellaneous equipment or accessories (E1399), the claim must include:

When billing a not otherwise classified drug (J7699), the claim must include:

The order for any drug must clearly specify the type of solution to be dispensed and the administration instructions for that solution. The type of solution is described by a combination of:

Dispensing fees:

References: L11488, PA A24942 (prior to 10/01/2015); L33370, A52466 (on/after 10/01/2015)

References:

Nebulizer Therapy Billing Reminders - Modifiers, Dispensing Fees, and Orders. (2016, February 24). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/nebulizer-therapy-billing-reminders-modifiers-dispensing-fees-and-orders-31612.html

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Allergy and Immunology Resources

  • ICD-10-CM Specialty Specific Code Book
  • Provider Documentation Guides
  • ICD-10-CM Comprehensive Code Books
  • and more...


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