AmeriHealth has updated its medical policy on nebulizers to include inhalation solutions. The title of the policy has also been updated to reflect this change. Medical Policy #05.00.15p: Nebulizers and Inhalation Solutions was posted as a Notification on December 27, 2017, and will go into effect January 26, 2018.

The following HCPCS codes, which represent inhalation drugs and solutions, have been added to this policy as medically necessary:

The following HCPCS codes, which represent compounded inhalation solutions, have been added to the policy and are considered not medically necessary and, therefore, not covered because commercially manufactured products are available:

In addition, when HCPCS code J7699 is billed to represent a compounded inhalation solution, it is considered not medically necessary and, therefore, not covered.

More information

To view the Notification for this policy, visit our Medical Policy Portal and select Accept and Go to Medical Policy Online. Then select Commercial under Active Notifications.