Respiratory Question for the Week of April 22, 2024

Question:

What is the significance of using the term “first hour” in code 94644, and how does this differ from other time-based codes that use the term “up to 1 hour”?

Answer:

Each CPT® time-based code is structured to reflect the procedure or service as performed in current clinical practice. Some codes in CPT use the term “up to 1 hour” indicating that the code is reportable for any time increment up to 60 minutes (e.g. 30 minutes, 45 minutes, 60 minutes). However, CPT code 94644 uses the term “first hour,” which restricts its use to only procedures lasting 60 minutes. An AMA communication to MedLearn in January 2007 stated that the 60-minute increment of time also applies to the add-on code +94645. When billing the add-on code +94645, it must be reported in conjunction with 94644. When billing for continuous therapy, be certain that the time increment is supported by documentation of start and stop time.

This question was answered in our Coding Essentials for RT/Pulmonary Function. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.