Respiratory Question for the Week of October 29, 2018

Question:

I am looking for guidelines for use of the code below:

Answer:

CPT^® code 94640 is a bundled code representing both diagnostic and therapeutic services. It includes different modes of treatment including aerosol generator, nebulizer, metered dose inhaler (MDI), or intermittent positive pressure breathing (IPPB) device. This code is appropriate to assign when documentation indicates the treatment is administered to a patient with an acute airway obstruction. It should not be reported for routine nebulizer or MDI treatments for patients with unrelated conditions. In addition, this CPT code is to be reported for the induction of sputum for diagnostic purposes.

The use of 94640 for intrapulmonary percussive ventilation (IPV) was clarified in September 2010 by the American Medical Association. Defined as a therapeutic modality, IPV is combined with a continuous nebulizer therapy to assist with elimination of secretions. In addition to the treatment, the therapist will typically instruct the patient on proper techniques for deep cough to improve mobilization and elimination of secretions. When billing for multiple (back-to-back) continuous inhalation therapy treatments, refer to CPT codes 94644 and 94645 when the total time recorded for the therapy meets the time increment of one hour or more as defined by the codes.

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