Respiratory Question for the Week of April 27, 2020

Question:

If multiple inhalation therapy treatments are provided during one episode of care, how can we determine whether we can bill 94644/94645 instead of 94640?

Answer:

When multiple, individual inhalation therapy treatments are provided during one episode of care, diligence in documenting the start and stop times of each session is critical, because the continuous therapy codes (94644 and 94645) are defined by a 60-minute increment of time. The medical record must support that a minimum of 60 minutes of therapy was provided in order to bill using CPT® code 94644 and that an additional 60 minutes of therapy was provided in order to report add-on code 94645. The guidelines do allow for the billing of multiple treatments using the continuous therapy code 94644, but the total time of each individual therapy session must add up to the minimum 60-minute requirement. If the start and stop times are not documented or the total amount of therapy time is less than 60 minutes, then it would not be appropriate to bill code 94644; you would instead report 94640. Coding guidelines do not allow for billing both 94640 and 94644/94645 for the same episode of care. Only one or the other is allowed. In other words, billing is for either single or continuous treatment.

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.