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Pulse Ox in the ED

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I am currently working on a build team to help our hospital go to Electronic Medical Records. Over the past 3 years, I have been working diligently to capture errors by poor documentation, over billing, etc. Lately we have been discussing Pulse Oximetry and how it is billed. My questions are as follows:

a. Is a single PO included with the ED Care Level (E/M)? Basically what I am asking here is if you have a Pt come in with SOB and the Triage RN performs a PO on them in Triage...do you bill for a single or include that with you E/M?
b. How do you determine MULTIPLE POs? Someone told me that anything over 1 is considered to be multiple however I can't find any documentation to support this.
c. Must the Dr write/order for ALL POs whether it be single, multiple or continuous?
d. Do you get reimbursed for these charges?

Any help offered would be greatly appreciated! Thank you in advance. :D


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If you are talking physician coding, PO is seldom coded spearately. Medicare does not recognize a profesional compnent. I believe it is also generally wrapped in on the facility side as well. There are a few payors who will pay so of course some billers will bill it. But generally viewed as wrapped into the level.



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I code ED for my facility. We code for Pulse Ox (only once) as long as the Physician orders it, and we do not include it in the level. I believe that some payors pay for it while others do not, but we code it whenever it is ordered.