Pulmonology Coding Alert

Question: Can I bill a pulse oximetry with the office visits when they are necessary? Do I use a modifier -25 attached to the office visit?

Massachusetts Subscriber

Answer: According to the Medicare physician fee schedule for 2001, the code for pulse oximetry (94760) carries an indicator of T. This means that if any other service payable under this schedule is provided on the same date as pulse oximetry, consider payment for it to be bundled into the other service(s). Under this guideline, application of modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) will not affect the status of the pulse oximetry reimbursement.