Wiki Pulse OX

dballard2004

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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
 
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.
 
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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