Wiki Billing pulse-ox 94760

[bonncruise]

I need some clarification on billing a pulse-ox 94760 on a sick visit. Specifically, Medicare vs Medicaid and third party. I recently billed a patient with Bravo insurance for asthma. The level of service was a 99213 and I billed the pulse-ox. We only got paid on the pulse-ox. Is a pulse-ox a covered service under the office visit? In order to get paid for the pulse-ox would there be a modifier that can be used? Please help.

Thanks,

Bonnie, Wilmington DE

 

[tdml97@yahoo.com]

I would put a mod 25 on OV & rebill

 

[pccBiller]

Medicare bundles pulse ox into office since approximately 2001. They consider it like a blood pressure and not separately payable whether or not you use a 25 modifier.

Other insurers will pay them with a 25 modifier, but many of them are now following Medicare's lead on this.