Budget-friendly ICD-10-CM Rapid Coder charts – code faster in 2019! |Learn More >>
Emergency Department Coding & Reimbursement Alert
Print Friendly and PDF

Reader Question: Take A Breath Before Billing For Nebulizer Treatments in the ED

- Published on Fri, Mar 17, 2017

Question: Our ED physician performs nebulizer treatments. What documentation gets this service paid?

Michigan Subscriber

Answer: Because the "incident-to" rules do not apply in the ED setting, the physician would have to perform the service themselves to bill for it with a medical necessity requirement and consideration of the supply cost. Occasionally, a physician's expertise is required to perform what would normally be a nursing function. Examples of this include starting a peripheral IV and difficult Foley catheter insertions.

Proper documentation for these treatments includes a description of the procedure and why the physician's expertise was required. Finding a reason why a physician's additional training would be useful in giving a nebulizer treatment, however, may be a hard case to make.

Get 14-Day Fully-Functional Free Trial of Physician Coder

Get access to all your specialty alerts and archived articles along with some comprehensive tools including:
  • Code Search for CPT®, HCPCS, ICD-9 and ICD-10
  • CCI Edits Checker
  • Part B Fees, MUEs
  • CPT-ICD-9 CrossRef
  • CPT® ↔ ICD-9 ↔ ICD-10 CM Crosswalk
  • LCD/NCD Lookup
  • CMS 1500 Claims Scrubber
  • NDC ↔ CPT/HCPCS CrossReference
First Name: *
Last Name: *
User Name: *
E-mail: *
Phone: *
Choose Speciality*
Please enter the characters shown in box*