Question:

Should I report code 94640 for multiple sequential inhalation treatments?

Answer:

Code 94640 should only be reported once during an episode of care regardless of the number of separate inhalation treatments that are administered. For multiple sequential inhalation treatments, either 94640 or 94644 will apply. 

If inhalation drugs are administered in a continuous treatment or a series of “back-to-back” treatments exceeding one hour, CPT codes 94644 (continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour) and 94645 (…; each additional hour) should be reported instead of CPT code 94640. When providing inhalation treatment for acute airway obstruction, Medicare will not pay for both 94640 and 94644 or 94645 if they are billed on the same day for the same patient. The coder must decide which of the two codes to submit for payment.

94640 Pressurized or nonpressurized 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
94644 Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour

This question was answered in our annual Respiratory Therapy Reimbursement & Compliance Update webcast. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

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