TMPPM 2010 > Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook > Physician > Procedures and Services > Aerosol Treatment

6.3 Procedures and Services

6.3.1 Aerosol Treatment

Aerosol treatments including vaporizers, humidifiers, nebulizers, and inhalers are appropriate methods of treatment for certain acute medical problems when breathing is compromised and should be submitted using procedure codes 94640, 94644, and 94645.

Medication(s) used in the aerosol therapy may be considered for separate reimbursement when billed by the physician.

Pulse oximetry (procedure codes 94760 and 94761) is considered part of an E/M visit and will not be reimbursed separately.

Procedure code 94664 will not be reimbursed separately.

Intermittent positive-pressure breathing (IPPB) treatments have been determined to be inappropriate for the treatment of most respiratory problems and are denied.

Payment for professional services for aerosol therapy is limited to the following diagnosis codes:

Medications used in aerosol therapy, when billed by the provider, are reimbursed separately and should be billed using the appropriate Healthcare Common Procedure Coding System (HCPCS) procedure code. A separate charge for saline used in aerosol therapy is denied as part of the aerosol therapy.

Refer to: Subsection 6.3.47, "Pentamadine, Aerosol" in this handbook.

Subsection 6.3.30.2, "Vaccine and Toxoid Procedure Codes" in this handbook for a list of diagnosis codes that are valid for the Bacillus Calmette-Guérin (BCG) vaccine.