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Pulmonology Coding:

Recognize These Codes for Remote Pulse Ox Monitoring

Question: Our pulmonology practice just started offering remote physiological monitoring (RPM) for our patients. Can you explain what codes we’ll need to report for pulse oximetry or respiratory flow rate RPM services?

Arkansas Subscriber

Answer: Use 99453 (Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); initial set-up and patient education on use of equipment) to report the setup of the equipment and teaching the patient how to use the equipment. This code cannot be reported more than once per episode of care, according to the CPT® guidelines.

When the physician monitors the patient’s condition for two to 15 days in a 30-day period, you’ll use 99445 (… device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period) to report the RPM service. However, if the monitoring occurs over 16 to 30 days, then you’ll assign 99454 (… device(s) supply with daily recording(s) or programmed alert(s) transmission, 16-30 days in a 30-day period) to report the services.

Important: You can report 99445 or 99454 only once in a 30-day period, and the two codes cannot be reported together in the same 30-day period.

Mike Shaughnessy, BA, CPC, Production Editor, AAPC

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