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Thread: Pulse OX

  1. #1

    Default Pulse OX

    AAPC: Back to School
    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
    Compliance Auditor

  2. #2
    Join Date
    Apr 2007
    naples, fl


    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.

  3. #3
    Join Date
    Apr 2007
    North Carolina

  4. #4


    Thanks so much!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  5. #5


    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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