PbiLinda
Contributor
Can I bill both these codes together, do I need a Modifier?
I would really apreciate your help.
Thank you,
Linda
I would really apreciate your help.
Thank you,
Linda
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Wiki codes 94060 and 94760
- Thread starter PbiLinda
- Start date
Erica1217
Guest
You can bill them together. They are not bundled per CCI, but the different payors may have their own guidelines. If I remember correctly, many payors do not reimburse 94760 when done with any other services on the same day.
Erica
Ericadesiree384
Contributor
These are the following limitations for 94760 for GHI Medicare. I'm not sure which payor you are inquiring about. They usually have their own rules but most adhere to these guidelines.
1. Routine testing (in the absence of signs or symptoms suggestive of desaturation) is not covered.
2. Continuous overnight monitoring in the home is covered only when the results are reliable in that setting.
The patient’s record must document that the oximeter is present and self-sealed and cannot be adjusted by the
patient. In addition, the device must provide a printout which documents an adequate number of sampling
hours, per cent of oxygen saturation and an aggregate of the results. This information must be available, if
requested.
3. In all instances, there must be a request documented in the medical record from a physician for these
services.
4. When pulse oximetry for oxygen saturation is utilized to monitor a patient’s respiratory status/oxygen
saturation during a surgical procedure, endoscopy, cardiac or pulmonary rehabilitation, oximetry is
considered included in the primary service and not separately reimbursable.
1. Routine testing (in the absence of signs or symptoms suggestive of desaturation) is not covered.
2. Continuous overnight monitoring in the home is covered only when the results are reliable in that setting.
The patient’s record must document that the oximeter is present and self-sealed and cannot be adjusted by the
patient. In addition, the device must provide a printout which documents an adequate number of sampling
hours, per cent of oxygen saturation and an aggregate of the results. This information must be available, if
requested.
3. In all instances, there must be a request documented in the medical record from a physician for these
services.
4. When pulse oximetry for oxygen saturation is utilized to monitor a patient’s respiratory status/oxygen
saturation during a surgical procedure, endoscopy, cardiac or pulmonary rehabilitation, oximetry is
considered included in the primary service and not separately reimbursable.