tci ED Coding & Reimbursement Alert - 2018 Issue 4

Reader Question: Consider Time When Selecting Breathing Treatment Codes

Question: Is it true that if the physician performs continuous inhalation treatment (94644) for less than an hour that we can report 94640? We can't find any CMS directives on this topic. Supercoder.com Subscriber Answer: In absence of CMS guidance, you should look to the AMA's instructions in the CPT® manual, as well as the corresponding specialty society, for advice. CPT® notes the following: 94640 – Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure...

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