© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 94642 involves the aerosol inhalation of pentamidine, a medication specifically utilized for the treatment or prophylaxis of pneumonia caused by Pneumocystis jiroveci, which was previously known as Pneumocystis carinii. This condition is particularly significant in immunocompromised patients, such as those with HIV/AIDS, where the risk of developing this type of pneumonia is elevated. Pentamidine is delivered in a fine aerosolized form, allowing for effective inhalation directly into the lungs. The medication is suspended in a gaseous propellant, which facilitates its conversion into fine particles that can be easily inhaled. The administration of pentamidine is performed using a nebulizer, a device that converts liquid medication into a mist, making it easier for patients to inhale the medication deeply into their lungs. The dosage and administration instructions for pentamidine are strictly followed as outlined in the medication prescription to ensure optimal therapeutic effects while minimizing potential side effects.
© Copyright 2025 Coding Ahead. All rights reserved.
The aerosol inhalation of pentamidine is indicated for the treatment or prophylaxis of pneumonia caused by Pneumocystis jiroveci. This condition is particularly relevant for patients who are immunocompromised, such as those with HIV/AIDS, where the risk of developing Pneumocystis pneumonia is significantly increased. The use of pentamidine is crucial in managing and preventing this serious respiratory infection in at-risk populations.
The procedure for aerosol inhalation of pentamidine involves several key steps to ensure effective delivery of the medication. First, the healthcare provider prepares the nebulizer, ensuring that it is clean and functioning properly. Next, a prescribed dose of pentamidine is measured and placed into the nebulizer's medication chamber. The nebulizer is then connected to a power source, and the patient is instructed to sit comfortably in an upright position to facilitate optimal inhalation. Once the nebulizer is activated, it generates a fine mist of pentamidine, which the patient inhales through a mouthpiece or mask. The patient is advised to breathe in slowly and deeply to ensure that the medication reaches the lungs effectively. The procedure typically lasts for about 30 minutes, during which the patient should remain calm and relaxed to maximize the inhalation of the aerosolized medication. After the treatment, the nebulizer is cleaned according to the manufacturer's instructions to prevent contamination and ensure the device's longevity.
After the aerosol inhalation of pentamidine, patients are typically monitored for any immediate adverse reactions, such as coughing, wheezing, or difficulty breathing. It is important for healthcare providers to assess the patient's response to the medication and ensure that they are stable before discharge. Patients may be advised to rinse their mouth after the procedure to minimize any potential irritation caused by the medication. Additionally, follow-up appointments may be scheduled to evaluate the effectiveness of the treatment and to determine if further doses are necessary for ongoing prophylaxis or treatment. Patients should also be educated on recognizing signs of Pneumocystis pneumonia and instructed to seek medical attention if they experience any concerning symptoms.
| Short Descr | AEROSOL INHALATION TREATMENT | Medium Descr | PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH | Long Descr | Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment or prophylaxis | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 5 - Incident To Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 217 - Other respiratory therapy |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GW | Service not related to the hospice patient's terminal condition | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2011-01-01 | Changed | Medium description changed. |
| 1991-01-01 | Added | First appearance in code book in 1991. |
Get instant expert-level medical coding assistance.