Basic Guidelines for Billing Nebulizers To know more about Nebulizer billing services you can call us 888-357-3226 at or write to us at info@medicalbillersandcoders.com. Click Here For More Information: https://bit.ly/34g8hIm Get a Free Quote: https://bit.ly/30DFr2z #texasmedicalbillingandcodingservices #medicalbillingauditing #medicare #medicalbillingandcoding #MBC #medicare #nebulizerbillingservices #medicalbillingfornebulizers #CPT #basicguidelinesforbillingnebulizers

1. Medical Billers and Coders

2. Nebulizers can be covered if the member’s ability to breathe
is severely impaired. Lung diseases such as chronic
obstructive pulmonary disease (COPD) and asthma are
characterized by airflow limitation that may be partially or
completely reversible. Pharmacologic treatment with
bronchodilators is used to prevent and/or control daily
symptoms that may cause disability for persons with these
diseases.
These medications are intended to improve the movement of
air into and from the lungs by relaxing and dilating the
bronchial passageways. Beta-adrenergic agonists are a
commonly prescribed class of bronchodilator drugs. They can
be administered via nebulizer, metered-dose inhaler, orally,
or dry powdered inhaler.

3. CMS Need Nebulizer Necessity
Nebulizers require an in-person or face-to-face interaction
between the beneficiary and their treating physician prior to
prescribing the item, specifically to document that the
beneficiary was evaluated and/or treated for a condition that
supports the need for the item(s) of DME ordered. A
dispensing order is not sufficient to provide these items.

4. 5-element order (5EO) WOPD (written order prior to delivery)
is required and must include the following elements:
• Beneficiary’s name
• Item of DME ordered. this may be general (for example,
hospital bed) or more specific (for example, continuous
glucose monitor [CGM])
• Signature of the prescribing practitioner
• Prescribing practitioner’s National Provider Identifier (NPI)
• The date of the order
• A completed 5EO within 6 months after the required
Affordable Care Act (ACA) 6407 face-to-face examination
• The supplier’s receipt of the 5EO before delivery of the
listed item(s)
• A date stamp or equivalent must be used to document the
5EO receipt date

5. Appropriate documentation for Nebulizers must include
the following items:
1. A recent order by the treating physician for refills,
2. A recent change in prescription, and
3. Beneficiary’s medical record within 12 months of the date
of service showing usage of the item

6. When a shipping service makes a delivery, the following
documentation elements must be present:
• Beneficiary’s name
• Delivery address
• Delivery service’s package identification number, supplier
invoice number, or alternative method that links the
supplier’s delivery documents with the delivery service’s
records
• A description of the items being delivered. The description
can be either a narrative description (for example, a
lightweight wheelchair base), and HCPCS Level II code, the
long description of an HCPCS Level II code, or a brand
name/model number
• Quantity delivered
• Date delivered
• Evidence of delivery

7. When you are ordering nebulizers and the drugs used in
them for your patients, documentation plays a crucial role.
Choosing the right CPT also ensures timely reimbursement
without denials. Medical billing for Nebulizers is a time-
consuming activity that requires constant follow-ups in case
of denials.
Medical Billers and Coders (MBC) can help you to reduce
documentation burden as well as can assist you in increasing
your revenue by addressing denials promptly.

8. Get in Touch
Medical Billers and Coders
Email : info@medicalbillersandcoders.com
Toll Free no: 888-357-3226