Pulse OX

dballard2004

True Blue
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1,168
Location
Gower, MO
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Is pulse oximetry no longer reimbursed by Medicare? I was taught it is considered a 5th Vital sign. My private practice certified coder informed me of this in 2007.
Secondly, If pulse oximetry is billed with a URI or sinusitis ICD-9, is that a problem. Shouldn't it only be billed with a pulmonary code e.g.: Cough, Bronchitis or Asthma
 

melaapc04

New
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5
Location
naples, fl
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Pulse ox is considered incidental by Medicare when billed with the E/M service. It is because it is a part of the vitals being taken during the visit (or, as you mentioned, it is called the "5th vital"). Hope this helps. If you need a reference, I just finished reading an article at www.chestjournal.org in the march issue about this.
 

lisigirl

Expert
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292
Location
Oakpark, Illinois
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At our facility we count pulse ox under "data reviewed" when determining MDM. You can't bill separately for pulse ox but it is a test from the medicine section of CPT that our physician is reviewing so we count the work.

Lisi, CPC
 
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