CPT® Code 94645 | Case2Code

Official Description

Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour (List separately in addition to code for primary procedure)

Common Language Description

The CPT® Code 94645 refers to the provision of continuous inhalation treatment with aerosol medication specifically for acute airway obstruction, billed for each additional hour of treatment. This procedure is commonly known as continuous bronchodilator therapy (CBT). During this treatment, a patient receives a bronchodilator medication that is aerosolized, meaning it is converted into fine particles suspended in a gaseous propellant. When the aerosol pressure is released, the medication is inhaled into the lungs as a fine spray. The primary action of the bronchodilator is to relax the smooth muscle surrounding the bronchioles and lung tissue, which may become constricted during episodes of acute airway obstruction, such as those experienced during an asthma attack or hypersensitivity reaction. This constriction can severely limit airflow, making it critical to administer the medication effectively. Throughout the treatment, healthcare providers perform periodic assessments to monitor the patient's response to the medication, adjusting the dosage as necessary to achieve the desired therapeutic effect. Once the symptoms indicating acute airway obstruction have resolved, the inhalation treatment is typically discontinued. It is important to note that CPT® Code 94644 should be used for the initial hour of continuous inhalation treatment, while CPT® Code 94645 is designated for each additional hour of treatment provided.

1. Indications

The indications for the use of CPT® Code 94645 include the following conditions where acute airway obstruction is present:

Asthma Attack A sudden worsening of asthma symptoms, characterized by difficulty breathing due to bronchoconstriction.
Hypersensitivity Reaction An acute response to allergens or irritants that leads to airway constriction and obstruction.
Chronic Obstructive Pulmonary Disease (COPD) Exacerbation A significant worsening of symptoms in patients with COPD, leading to increased difficulty in breathing.

2. Procedure

The procedure for administering continuous inhalation treatment with aerosol medication involves several key steps:

Step 1: Patient Assessment Prior to initiating treatment, a thorough assessment of the patient's respiratory status is conducted. This includes evaluating the severity of the acute airway obstruction and determining the appropriate bronchodilator medication to be used.
Step 2: Medication Preparation The selected bronchodilator medication is prepared for aerosolization. This involves ensuring that the medication is in the correct formulation and dosage for effective delivery via inhalation.
Step 3: Inhalation Setup The patient is positioned comfortably, and the inhalation device is set up to deliver the aerosolized medication. This may involve connecting the device to a power source and ensuring that all components are functioning properly.
Step 4: Administration of Treatment The continuous inhalation treatment is initiated, allowing the patient to inhale the aerosolized medication. The healthcare provider monitors the patient closely during this time, observing for any changes in respiratory status or adverse reactions.
Step 5: Ongoing Monitoring and Dosage Adjustment Throughout the treatment, periodic assessments are performed to evaluate the patient's response. The dosage of the bronchodilator may be adjusted based on the patient's needs and the effectiveness of the treatment.
Step 6: Discontinuation of Treatment Once the patient's symptoms of acute airway obstruction have resolved, the inhalation treatment is discontinued. The healthcare provider will document the treatment duration and any relevant observations made during the procedure.

3. Post-Procedure

After the completion of continuous inhalation treatment, the patient should be monitored for any residual symptoms or potential side effects from the bronchodilator medication. Follow-up assessments may be necessary to ensure that the airway obstruction has fully resolved and to determine if further treatment is required. Patients may also receive instructions on managing their condition and recognizing signs of future exacerbations. Documentation of the treatment, including the duration and patient response, is essential for accurate coding and billing purposes.

Short Descr	CBT EACH ADDL HOUR
Medium Descr	CONTINUOUS INHALATION TREATMENT EA ADDL HR
Long Descr	Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour (List separately in addition to code for primary procedure)
Status Code	Active 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	Items and Services Packaged into APC Rates
Type of Service (TOS)	1 - Medical Care
Berenson-Eggers TOS (BETOS)	T2D - Other tests - other
MUE	2
CCS Clinical Classification	217 - Other respiratory therapy

This is an add-on code that must be used in conjunction with one of these primary codes.

94644

MPFS Status: Active Code APC Q1 CPT Assistant Article Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour

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.

Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.