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Kelly Posted Wed 24th of January, 2018 10:55:21 AM
*Needing direction for charging continuous med neb (94644) and/or additional (94545). It is true that when the documentation reflects< 1 hour run time, CPT 94640 can be reported? Please provide CMS guideline in your response. 94644-Continuous inhalation tx w/aerosol meds for acute airway obstruction; 1st hr 94545-Continuous inhalation tx w/aerosol meds for acute airway obstruction;eaaddlhr 94640-Pressurized or non-pressurized inhalation tx 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 breathing (IPPB) device
SuperCoder Answered Thu 25th of January, 2018 01:48:03 AM

Hi Kelly,

FYI, Bronchodilator administration codes (94640, 94644, and 94645) cannot be submitted by providers in facility-based settings. Please see below link as guidlines to help bill the above codes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204795/.

Hope it helps.

Kelly Posted Mon 29th of January, 2018 14:07:09 PM
Can you please answer my question regardless of the setting? It is true that when the documentation reflects< 1 hour run time, CPT 94640 can be reported? Please provide CMS guideline in your response
SuperCoder Answered Tue 30th of January, 2018 11:34:35 AM

There is no CMS guidance that I can find for this service.  In absence of CMS guidance, guidance should come from CPT/AMA in conjunction with the corresponding specialty society.  In this case, CPT states:

  • 94640 – Pressurized or non-pressurized 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 breathing [IPPB] device.

(For more than 1 inhalation treatment performed on the same date append modifier 76)

(Do not report 94640 in conjunction with 94060, 94070 or 94400)

 

  • 94644 – Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour

(For services of less than 1 hour, use 94640)

 

  • 94645 – each additional hour (List separately in addition to code for primary procedure)

(Use 94645 in conjunction with 94644)

 

This is supported by the AARC.  AACP also supports the AMA/CPT guidance. 

https://www.aarc.org/wp-content/uploads/2014/10/aarc-coding-guidelines.pdf

Kelly Posted Tue 30th of January, 2018 13:34:54 PM
Wonderful! Thank you so much!!!
SuperCoder Answered Tue 30th of January, 2018 23:39:14 PM

Happy to help !
 

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