← Return to 7% Saline Prescription and Medicare Part B payment quandry

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@carolinediehl

Here is what a search on Microsoft Copilot AI had to say: Yes, Medicare Part B generally covers inhalation drugs like 7% saline solution if they are prescribed by a physician and used with a nebulizer, which is considered durable medical equipment (DME). However, coverage often depends on the specific diagnosis code provided by the physician and whether the pharmacy processes the prescription correctly under Medicare Part B.

If you're facing challenges with coverage, it might help to:
1. Confirm with your doctor that the correct diagnosis code is being used.
2. Ensure the pharmacy is billing it under Medicare Part B, not Part D.
3. Consider reaching out to Medicare or your secondary insurance for clarification.

The correct diagnosis code for ordering a 7% saline solution for use with a nebulizer depends on the underlying medical condition being treated. Common conditions that might require this treatment include **cystic fibrosis**, **bronchiectasis**, or **chronic obstructive pulmonary disease (COPD)**. Each condition has its own ICD-10 diagnosis code, such as:

- **E84.0** for cystic fibrosis with pulmonary manifestations.
- **J47.9** for bronchiectasis, unspecified.
- **J44.9** for COPD, unspecified.

It's essential to consult with the prescribing physician to ensure the diagnosis code aligns with the patient's specific medical condition and treatment plan. If you're dealing with insurance coverage, the physician or pharmacist might also need to verify the code with the insurer.

Hope this is helpful.

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Replies to "Here is what a search on Microsoft Copilot AI had to say: Yes, Medicare Part B..."

Very helpful. Been working through all of this as you have laid out. Good to know I’m not crazy but just need to persist. Get through to someone who isn’t just gaslighting? It is what it feels like even if it is something more benign. THANK YOU 🙏🏽

Did not work. Never has.