Pulmonology Coding Alert

Reader Question:

Reporting E/M Services and 94762 Is a No-No

Question: Is it true that I should only report 94762 as a technical component? Therefore, if a physician in our practice interprets the overnight pulse oximeter reading, I should not bill any code unless the patient is physically present in the office? 

But if the overnight pulse oximeter belongs to the physician who also interprets the reading, shouldn't I report code 94762 for the overnight pulse ox taken home by the patient? Should I also report an additional appropriate E/M code or should I report 94762 once the patient returns the oximeter and the physician interprets the reading?

West Virginia Subscriber 

Answer: Code 94762 (Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring [separate procedure]) does not include payment for any work the physician completed. Code 94762 covers technical services only.

Warning: You can report this code on the same day that the physician provides E/M services, as long as the E/M is medically necessary.

You should report 94762 when the patient returns the overnight pulse oximetry and the physician interprets the readings.

Remember: The other codes for ear or pulse oximetry - 94760 (Noninvasive ear or pulse oximetry for oxygen saturation; single determination) or 94761 (... multiple determinations) - also do not cover work the physician may complete. You should not report these codes if the physician provided another E/M service on the same day.