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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j7605-arformoterol-inhalation-solution-15mcg-dme
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    HCPCS Level II J7605: Arformoterol Inhalation Solution, Unit Dose

    HCPCS Level II code J7605 represents FDA‑approved arformoterol inhalation solution in a unit‑dose form (15 micrograms) supplied for administration through durable medical equipment; this code is used to bill the medication product itself for inhalation therapy delivered via DME in outpatient or home care settings where nebulized bronchodilator treatment is provided.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only).

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 68-year-old with chronic obstructive pulmonary disease (COPD) who presents to a durable medical equipment (DME)-affiliated outpatient infusion/respiratory clinic for administration of inhaled arformoterol nebulizer solution. The patient has a long history of inhaled bronchodilator therapy and requires a unit-dose, FDA-approved arformoterol product (J7605) delivered via a facility-supplied nebulizer. The clinical workflow begins with verification of the prescription and current medication list by a respiratory therapist or nurse, confirmation of patient identity and allergies, and assessment of baseline vitals and lung auscultation. The therapist assembles the DME nebulizer, prepares the single-use 15 microgram unit-dose vial per manufacturer instructions, and administers the inhalation solution while monitoring oxygen saturation and heart rate. Post-administration observation includes reassessment of respiratory status, documentation of response and any adverse effects (tachycardia, tremor, paradoxical bronchospasm), and billing staff applying J7605 for the medication administered along with the appropriate place-of-service and service modifiers. Typical sites of service include outpatient DME supplier locations, hospital outpatient departments, ambulatory care clinics, and skilled nursing facilities where DME nebulizer administration is provided. Payers involved commonly include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    94640Pressurized or non-pressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes (eg, nebulizer, metered dose inhaler, DPI)Commonly billed for the administration time and respiratory therapy service when arformoterol is given by nebulizer in a clinic or facility.

    | 94010 | Bronchospasm evaluation (ie, peak flow or spirometry pre/post bronchodilator) | Performed before and/or after inhaled bronchodilator administration to document therapeutic response.

    | 94760 | Noninvasive ear or pulse oximetry for oxygen saturation; single determination | Used to document oxygen saturation monitoring during and after nebulized bronchodilator administration.

    | 99070 | Supplies and materials (eg, saline, gauze, nebulizer supplies) provided by the physician over and above those usually included with the office visit | Used to report billable consumable supplies associated with DME nebulizer administration when payer allows.

    | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes | Frequently used for the clinician visit that results in prescription and oversight of inhaled arformoterol therapy.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RC0000XCardiovascular Disease PhysicianAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
    207RP1001XPulmonary Disease PhysicianAn internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational an…
    363LA2200XAdult Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    224ZR0403XDriving and Community Mobility Occupational Therapy AssistantOccupational therapy assistants contribute to the completion of an individualized occupational therapy driving and community mobility evaluation by ad…
    3336M0003XManaged Care Organization PharmacyA pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO's c…
    156FX1201XOptometric Assistant TechnicianAn optometric assistant assists optometrists by performing duties, including but not limited to, customer service, basic eye testing, and patient educ…

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    B44.9Aspergillosis, unspecified
    E66.9Obesity, unspecified
    F17.200Nicotine dependence, unspecified, uncomplicated
    J18.9Pneumonia, unspecified organism
    J20.9Acute bronchitis, unspecified
    J21.9Acute bronchiolitis, unspecified
    J43.0Unilateral pulmonary emphysema [MacLeod's syndrome]
    J43.9Emphysema, unspecified
    J44.0Chronic obstructive pulmonary disease with (acute) lower respiratory infection
    J44.1Chronic obstructive pulmonary disease with (acute) exacerbation

    Showing 1–10 of 28

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Chimeric Antigen Receptor (CAR) T-Cell TherapyColorado Rocky Mountain Health Plans2026-08-01
    Allogeneic Hematopoietic Progenitor Cell TherapyAmbetter Georgia2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Idaho Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for New Jersey Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Ohio Only)UnitedHealthcare2026-08-01
    Reblozyl (luspatercept-aamt) Medical Benefit Drug PolicyUnitedHealthcare2026-08-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

    • More pages

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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