Primary Care Coding Alert

Question: Can we bill for oxygen therapy given to patients in the office during an E/M service?

California Subscriber

Answer: As oxygen therapy during office visits by patients is part of the E/M service, you cannot code the therapy separately. There is also no CPT code specified for oxygen therapy administered in the office. In these instances, only the appropriate E/M code should be reported (99201-99215).

Also, you should include prolonged services codes (99354-99355) to bill for the extra time where this is applicable. These prolonged services codes, however, can be billed only when there is direct (face-to-face) patient contact. For example, assume the E/M service is a mid-level service for an established patient that lasts 50 minutes, including the oxygen therapy; you would code this as 99213 plus +99354:

• 99213 -- Office or other outpatient visit for the evaluation and management of an established patient

• +99354 -- Prolonged physician service in the office or other outpatient setting requiring direct (face-to-face) patient contact beyond the usual service; first hour (List separately in addition to code for office or other outpatient Evaluation and Management service).