Pulmonology Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.



Question: How can I get reimbursed for an oximetry reading (94760) and an office evaluation and management visit on the same day? What about multiple oximetry readings such as CPT 94761 ?

Oklahoma Subscriber


Answer: Effective Jan. 1, 2000, procedure codes 94760 (noninvasive ear or pulse oximetry for oxygen saturation; singe determination) and 94761 (noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations [e.g., during exercise]) are considered bundled services and, therefore, are not separately reimbursable by Medicare when billed with other physician fee schedule services by the same provider on the same day. Other carriers often follow Medicare guidelines for reimbursement. If Medicare doesnt pay, private carriers generally wont pay either.

Answered by Cynthia DeVries, RN, BSN, CPC, coding and reimbursement coordinator for Lee Physicians Group, a 140-provider, multispecialty practice in Fort Myers, Fla.