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Pulse OX

  1. #1
    Overland Park, KS
    Default Pulse OX
    Medical Coding Books
    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
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

  2. #2
    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 in the march issue about this.

  3. #3
    North Carolina
    Rebecca CPC, CPMA, CEMC

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  4. #4
    Overland Park, KS
    Thanks so much!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

  5. Default
    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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