Pediatric Coding Alert

The pediatrician and nurse perform seven procedures (coding options follow each procedure):

1-2. Pulse oximetry x 2:
94760 x 2 (Noninvasive ear or pulse oximetry for oxygen saturation; single determination)
or 94760-59 (Distinct procedural service) x 2

3. Spirometry before and after bronchodilation:
94060 (Bronchospasm evaluation: spirometry as in 94010, before and after bronchodilator [aerosol or parenteral])
or 94060-59

4. Spirometry:
94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation)
or 94010-59

5-6. Bronchodilation x 2:
94640, 94640-76 (Repeat procedure by same physician)
or 94640, 94640-51 (Multiple procedures)
or 94640 x 2 or 94640-59 x 2

7. Training:
optimal 94664; if the payer accepts 94664, bill it
or 94664-59
or an E/M (include the training in 9921x) and appeal. And two services (applicable codes follow):

8. An established patient office visit: 9921x, probably 99214-99215
or 9921x-25. 9. An emergency service: 99058.