How To Use CPT Code 94645

CPT 94645 describes the continuous inhalation treatment with aerosol medication for acute airway obstruction, specifically for each additional hour of treatment. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 94645?

CPT 94645 can be used to describe the continuous inhalation treatment with aerosol medication for acute airway obstruction, specifically for each additional hour of treatment. This code is used when the provider administers inhalation therapy to a patient for more than one hour to treat acute airway obstruction.

2. Official Description

The official description of CPT code 94645 is: ‘Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 94644 for the initial hour of treatment.

3. Procedure

1. The provider continues the administration of an inhalation aerosol treatment with medication for more than one hour.
2. This procedure is performed to treat acute airway obstruction.
3. The provider uses a nebulizer or a hand-held nebulized aerosol device to deliver the medication to the patient.
4. After completing the treatment, the provider discusses the next steps with the patient or their parent or guardian.

4. Qualifying circumstances

Patients eligible to receive CPT 94645 services are those with acute airway obstruction that requires continuous inhalation treatment with aerosol medication. This code is used when the treatment time exceeds one hour. The provider must explain the risks and benefits of the treatment to the patient or their parent or guardian. Inhalation therapy is commonly used to treat respiratory diseases and conditions such as asthma, bronchitis, chronic obstructive pulmonary disease (COPD), and emphysema.

5. When to use CPT code 94645

CPT code 94645 should be used when the provider administers continuous inhalation treatment with aerosol medication for more than one hour to treat acute airway obstruction. This code is an add-on code and should be reported in addition to the primary procedure code, CPT 94644, for the initial hour of treatment.

6. Documentation requirements

To support a claim for CPT 94645, the provider must document the following information:

• Reason for the continuous inhalation treatment with aerosol medication
• Duration of the treatment session
• Details of the medication administered
• Any complications or adverse reactions observed
• Discussion of next steps with the patient or their parent or guardian

7. Billing guidelines

When billing for CPT 94645, ensure that the treatment time exceeds one hour and that the primary procedure code, CPT 94644, is also reported. Do not report CPT 94645 if the patient routinely uses the devices for treatment at home, unless there are unusual circumstances. Medicare and many private payers do not allow reporting of CPT 94640 in addition to CPT 94644 and CPT 94645 during the same visit. It is important to review billing edits and guidelines specific to the payer to ensure accurate reporting.

8. Historical information

CPT 94645 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates to the code since its addition.

9. Examples

1. A patient with acute asthma exacerbation receives continuous inhalation treatment with aerosol medication for two hours to relieve airway obstruction.
2. A patient with bronchitis requires continuous inhalation treatment with aerosol medication for three hours to alleviate acute airway obstruction.
3. A patient with COPD undergoes continuous inhalation treatment with aerosol medication for four hours to manage acute airway obstruction.
4. A patient with emphysema receives continuous inhalation treatment with aerosol medication for five hours to address acute airway obstruction.
5. A patient with acute respiratory distress syndrome requires continuous inhalation treatment with aerosol medication for six hours to treat acute airway obstruction.
6. A patient with severe pneumonia undergoes continuous inhalation treatment with aerosol medication for seven hours to alleviate acute airway obstruction.
7. A patient with acute respiratory failure receives continuous inhalation treatment with aerosol medication for eight hours to manage acute airway obstruction.
8. A patient with acute bronchiolitis requires continuous inhalation treatment with aerosol medication for nine hours to address acute airway obstruction.
9. A patient with acute respiratory distress receives continuous inhalation treatment with aerosol medication for ten hours to treat acute airway obstruction.
10. A patient with acute respiratory failure undergoes continuous inhalation treatment with aerosol medication for eleven hours to alleviate acute airway obstruction.