Wiki Pulse OX

[dballard2004]

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]

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.

 

[RebeccaWoodward*]

Also....(NC)

http://www.cms.hhs.gov/mcd/viewlcd.asp?lcd_id=6465&lcd_version=19&show=all

 

[dballard2004]

Thanks so much!

 

[lisigirl]

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