Posted by Martha on 10/30/2009, 7:36 pm, in reply to "Re: Joe, found this, check it out"
68.12.160.104
This looks like the correct codes for pulse oximetry:
The following procedure codes are used when billing for pulse oximetry services:
CPT 94760 Non-invasive ear or pulse oximetry for oxygen saturation;
single determination.
CPT 94761 Non-invasive ear or pulse oximetry for oxygen saturation;
multiple determinations (e.g. during exercise)
CPT 94762 Non-invasive ear or pulse oximetry for oxygen saturation; by
continuous overnight monitoring (separate procedure)
Reasons for pulse oximetry (94760 and 94761) include:
1. Patient exhibits signs or symptoms of acute respiratory dysfunction such
as: Tachypnea, Dyspnea, Cyanosis, Respiratory distress, Confusion and
Hypoxia.
2. Patient has chronic lung disease, severe cardiopulmonary disease, or
neuromuscular disease involving the muscles of respiration, and oximetry
is needed for at least one of the following reasons:
a. Initial evaluation to determine the severity of respiratory impairment.
b. Evaluation of an acute change in condition.
c. Evaluation of exercise tolerance in a patient with respiratory disease.
d. Evaluation to establish medical necessity of oxygen therapeutic
regimen.
3. Patient has sustained severe multiple trauma or complains of acute
severe chest pain.
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4. The patient is under treatment with a medication with known pulmonary
toxicity, and it may be necessary to monitor for potential adverse effects of
therapy.
When 94760 or 94761 are billed with an E/M code, the routine oximetry is
incidental to a provider’s service and therefore, like other vital sign
measurements is considered part of the provider’s service when billed with an
E/M code.
When pulse oximetry for oxygen saturation is utilized to monitor a patient’s
respiratory status/oxygen saturation during a surgical procedure, the service is
bundled into the surgical/anesthesia service and not separately reimbursable
(i.e., anesthesia or provider surgical procedure).
Responses: