Pulmonology Coding Alert

Question: Medicare states that they dont cover 94760 unless its the only service done. If we bill it, knowing it wont be covered, are we violating Medicare compliance?

New York Subscriber

Answer: In January 2000, Medicare began bundling 94760 (noninvasive ear or pulse oximetry for oxygen saturation; single determination) and 94761 (... multiple determinations, [e.g., during exercise]) into any other services performed on the same date. Payment for these services will be made only if they are the only services performed. Since these are considered bundled, you should not bill the services to Medicare separately.

Susan Callaway-Stradley, CPC, CCS-P, a coding consultant and educator in North Augusta, S.C.