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Nebulizers

Date: 05-22-2017

  • Overview
  • Eligible Providers
  • Eligible Recipients
  • Covered Services
  • Authorization
  • Billing
  • Overview

    Nebulizers administer vaporized medication to individuals receiving nebulized medications.

    Eligible Providers

    The following providers may provide spirometers:

  • • Federally qualified health center
  • • Home health agencies
  • • Indian Health Services
  • • Medical suppliers
  • • Pharmacies
  • • Rural health clinic
  • Third Party Liability (TPL) and Medicare

    Providers must meet any provider criteria, including accreditation, for third party insurance or Medicare. This is to assist recipients for whom MHCP is not the primary payer.

    Eligible Recipients

    Nebulizers are covered for eligible MHCP recipients with a variety of respiratory or pulmonary conditions and diseases and other serious conditions requiring nebulized medications.

    Covered Services

    The following services (codes) are covered:

  • • E0570 (with compressor)
  • • E0572 (aerosol compressor, adjustable pressure, light duty for intermittent use)
  • • E0574 (ultrasonic/electronic aerosol generator with small volume nebulizer)
  • • E0575 (ultrasonic, large volume)
  • • E0580 (durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter)
  • • E0585 (with compressor and heater)
  • For codes E0570, E0572, E0574 and E0585, one nebulizer is allowed every five years. For code E0580, one nebulizer is allowed every three years. If more than the allowed quantity is medically necessary, providers must submit a claim with an attachment explaining the circumstances requiring replacement.

    Included in Initial Dispensing
    The following are included in the initial dispensing of the nebulizer:

  • • Compressor
  • • Mask
  • • Mouthpiece
  • • Reusable nebulizer
  • • Tubing
  • Separately Billed
    The following are billed separately from the nebulizer:

  • • Disposable mouthpieces
  • • Face mask
  • • Replacement of disposable hand held nebulizer
  • • Replacement tubing
  • Authorization

  • Authorization is always required for rental of E0575. All authorization requests must include diagnosis or order for tobramycin.
  • Submit authorization request and required documentation to the authorization medical review agent.

    Billing

    When billing with an approved authorization:

  • • Use MN–ITS 837P Professional
  • • Refer to the MN–ITS User Guide for DME, Medical Supplies, Prosthetic and Orthotic Services for detailed instructions
  • • Enter the ordering provider in the Other Provider Types section of the Provider tab of the MN–ITS Interactive Claim
  • • Use the correct HCPCS code and the modifier NU or RR as noted on the authorization
  • Refer to the Billing section on the main Equipment & Supplies page and the Detailed Written Orders section for additional information.

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    © 2017 Minnesota Department of Human Services Updated: 5/22/17 2:44 PM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 5/22/17 2:44 PM