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Breathing Treatment

Bernadette Posted Tue 16th of December, 2014 12:25:16 PM

Hi,

A 5 month old baby was heavily congested and our doctor decided to do a steam treatment with saline using the nebulizer machine and supplies to help break up the congestion. Should we just report the supply code HCPCS code 'A7003' for the nebulizer supplies? We don't believe using CPT code ' 94640" is appropriate as we did not use a nebulizer medication. What would be the proper coding for this?
Please advise.
Thank you!

SuperCoder Answered Tue 16th of December, 2014 13:52:30 PM

Thanks for your question. Billing 94640; Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes (eg, with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing [IPPB] device) would not be appropriate in this scenario. Part of the clinical responsibility of this service involves administering a bronchodilator which is a medication that helps relax the muscles around the airways and allow the airways to open up. This was not done in this case. Billing A7003; administration set, with small volume nonfiltered pneumatic nebulizer, disposable would be the best option.

Bernadette Posted Mon 29th of December, 2014 10:18:16 AM

Hi,

Could the saline be billed? If so, what would be the appropriate code?

SuperCoder Answered Fri 02nd of January, 2015 12:09:28 PM

Thanks for your patience. Review HCPCS codes A4217 and A4218 and determine which code is appropriate based on your documentation.

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