New Coding Changes Impact Respiratory Therapy
December 11, 2002
The new CPT 2003 by the American Medical Association includes the following coding changes that affect respiratory therapy:
- The definition of CPT 94640 was modified from:
“Nonpressurized inhalation treatment for acute airway obstruction”
To read:
“Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes (e.g., with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device.”
- The following CPT codes were deleted:
94650 Intermittent positive pressure breathing (IPPB) treatment, air or oxygen, with or withoutnebulized medication; initial demonstration and or evaluation.
94651 Intermittent positive pressure breathing (IPPB) treatment, air or oxygen, with or without nebulized medication; subsequent.
94652 Intermittent positive pressure breathing (IPPB) treatment, air or oxygen, with or without nebulized medication; newborn infants.
- For more than one inhalation treatment performed on the same date, you must now attach modifier -76 to CPT 94640. This is not a change. The AMA placed extra emphasis on this rule by placing it in print.
- The definition of CPT 94664 was modified from:
“Aerosol or vapor inhalations for sputum mobilization, bronchodialation, or sputum induction for diagnostic purposes; initial demonstration and/or evaluation”To read:
“Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device.”
94664 can be reported one time only per day of service.
- The following CPT code was deleted:
94665 Aerosol or vapor inhalations for sputum mobilization, bronchodialation, or sputum induction for diagnostic purposes; subsequent].
It is AARC’s interpretation that when a respiratory therapist demonstrates or evaluates a patient’s utilization of breathing treatments such as MDIs, nebulizers, or IPPBs, they should use CPT 94664. This code can only be reported one time per day of service, when physician ordered, performed and properly documented as to necessity.
All treatments performed, including the treatment performed with the initial demonstration and/or evaluation, should be billed with CPT 94640. For more than one inhalation treatment performed on the same date, attach modifier -76. It is not anticipated that these coding changes will greatly affect current reimbursement levels.
The AARC’s interpretation on the use of these codes is only for the purposes of explaining these CPT code changes. It is not the official position of the AMA or the Medicare program. Respiratory therapists are encouraged to work with their billing departments and their Medicare contractors to ensure the appropriate use of these codes.
