Pulmonology Coding Alert
Pay Attention to 'T' Status With 94760
New York Subscriber
Answer: If the service takes place in an outpatient setting, you may also report the type of access required for the technician to obtain the specimen.
You could report code 36600 (Arterial puncture, withdrawal of blood for diagnosis) or 36620 (Arterial catheterization or cannulation for sampling, monitoring or transfusion [separate procedure]; percutaneous), depending on which method the technician uses and the documented details of the procedure.
During this procedure, the physician may insert the needle or catheter percutaneously into a radial, brachial or femoral artery to obtain a single arterial blood sample for blood gas analysis. If the physician removes the needle after obtaining the specimen, you should report 36600. However, if the physician places an indwelling arterial catheter percutaneously to monitor the patient during frequent intervals, you should report 36620.
Warning: You should not report these services separately in an inpatient setting. You should not report the arterial blood gas (82805-82810) if your physician does not process and analyze the specimen.
If the physician obtains a specimen that he then sends to an independent lab, the lab should report the appropriate code for the blood gas analysis.
Bonus: Also, if the physician provides an E/M service on the same day, you may report the visit, when appropriate, in addition to the other services.
If the physician measures oxygen saturation indirectly (such as pulse oximetry), you should only report 94760 (Noninvasive ear or pulse oximetry for oxygen saturation; single determination).
Exception: If the physician provides an E/M service on the same day as pulse oximetry, you should only report the visit because 94760 holds a "T" status. This means that the carrier should not reimburse you for 94760 when you report it with any other payable service on the same date.
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