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Otolaryngology Coding Alert

READER QUESTION ~ Use Modifier to Report Inhalations

Question: When I bill two units of 94640, insurers deny the second charge as duplicative. Should I appeal these denials?

New Jersey Subscriber Answer: Actually, you are incorrectly billing the second inhalation treatment. Instead of using units -for more than one inhalation treatment performed on the same date, append modifier 76- (Repeat procedure by same physician), according to the parenthetical instruction following 94640 (Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes [e.g., with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device]).  

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