2025 HCPCS code J7681
Terbutaline sulfate, inhalation solution, compounded product, administered through DME, unit dose form, per milligram.
Modifiers may be applicable to J7681 depending on specific circumstances such as discarded drug amounts or other factors impacting the delivery or administration of the drug, as indicated by the J-modifiers JW and JZ.
Medical necessity for the use of terbutaline sulfate must be established based on the patient's diagnosis and the severity of their respiratory symptoms. This typically involves documentation of airway obstruction or bronchospasm, along with a justification for the need for a compounded formulation and administration through DME.
In simple words: This code covers the cost of 1 milligram of terbutaline sulfate, a medicine that helps open up the airways in your lungs. It's specifically for the kind that's mixed by a pharmacist and given through a nebulizer or similar device.
Terbutaline sulfate is a bronchodilator that relaxes airway muscles and improves airflow in the lungs. This HCPCS code represents 1 mg of compounded terbutaline sulfate, prepared in unit dose form for administration via durable medical equipment (DME), such as a nebulizer.
Example 1: A patient with asthma experiencing an acute exacerbation requires nebulized terbutaline sulfate. The dose administered is 1mg, and the code J7681 is used for billing., A patient with chronic bronchitis regularly uses nebulized terbutaline sulfate to manage their symptoms. Each unit dose of 1mg is billed using J7681., A patient with emphysema is prescribed terbutaline sulfate for inhalation via a nebulizer during a hospital stay. Each 1mg unit dose administered is billed using J7681.
Documentation should include the diagnosis necessitating the terbutaline sulfate, the dosage administered (1mg per unit of J7681), the method of administration (through DME such as a nebulizer), and the medical necessity for the compounded unit dose formulation.
- Specialties:Pulmonology, respiratory therapy, allergists/immunologists, and potentially emergency medicine.
- Place of Service:Applicable places of service may vary depending on the specific clinical scenario, but typically include physician offices, outpatient clinics, hospitals (inpatient and outpatient), and potentially patient homes if DME is used there. For detailed place of service options, refer to iFrameAI product.