Can CPT codes 94060 and 94640 be billed together?

Can CPT codes 94060 and 94640 be billed together?

For payers that follow Medicare’s lead and NCCI edits, you can’t report 94640 with 94060. So if you perform both, bill 94060, which has a higher relative work value.

Can CPT code 94664 and 94640 be billed together?

To bill both 94640 and 94664 on the same date of service, there must be documentation supporting that the procedures were separate and distinct from one another. The medical record should include a request for each procedure, and therapist documentation should support that procedures occurred at separate times.

How many times can you bill 94640?

CPT 94640 should only be reported once during a single patient encounter regardless of the number of separate inhalation treatments that are administered. CMS considers the entire time a patient is in observation status or in the Emergency Room as a single encounter.

What is the Mue for 94640?

Medical Unlikely Edit
CPT code 94640 has a Medical Unlikely Edit (MUE) of “2”.

How do I bill a 94640?

If the patient receives a nebulizer treatment of less than 1 hour (CPT code 94640) during an episode of care and subsequently returns on the same date of service to the urgent care to receive another nebulizer treatment of less than 1e hour, then you would bill CPT code 94640 and append modifier -76, “Repeat procedure …

Does CPT code 94060 need a modifier?

A provider billed CPT code 94060 (Evaluation of Wheezing) with no modifier for date of service. The same provider also billed CPT code 99212 for the same patient on the same date of service without a modifier. CPT code 99212 should not be billed if the E/M service was related to the code 94060.

What does Mue 2 mean?

2. MUE edits with an MUE Adjudication Indicator (MAI) of “2” (Date of Service Edit: Policy): a. The MUE value is an absolute date of service limit that may not be overridden or bypassed with a modifier.

Can we BILL 94640 twice a day?

Inhaler Techniques The code may only be used once per day. For example, it cannot be billed at the same time/same visit as 94640. The code should not be reported for patients who routinely self-administer (e.g. prior to their hospitalization).

Does Medicare cover 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. Generally, it would be the code that has the greatest volume/quantity.

What Revenue Code is billed with procedure 94640?

For an item to be considered DME, it must be used in the home. This is not the case with outpatient hospital nebulizer inhalation treatment. Therefore, report the appropriate procedure code, 94640. There is no appropriate HCPCS code for the Albuterol, therefore, report it as a packaged drug using revenue code 250.

What is medical code 94640?

The Current Procedural Terminology (CPT) code 94640 as maintained by American Medical Association, is a medical procedural code under the range – Pulmonary Diagnostic Testing and Therapies.

Is 96372 covered by Medicare?

Similarly, 96372 and 96402 will be allowed for indicated diagnoses beyond those in this LCD. Chart documentation must support the diagnosis on the claim, and be made available to Medicare upon request. For one-year implants, the chart must document and justify the clinician?s belief that the patient?s life expectancy is at least one year.

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