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Thread: Overnight pulse oximetry (CPT code 94762)

  1. #1
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    Gulf to Bay Chapter in Clearwater Florida
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    Default Overnight pulse oximetry (CPT code 94762)

    We are having trouble receiving reimbursement for the professional component of (CPT code 94762) with modifier-26, is it appropriate to append modifier -26 or modifier – 52 for reduce services?


    We are receiving denials stating invalid modifier, when using modifier 26
    I do not think it is appropriate to use modifier-52, for professional component, However is this appropriate?

    Thanks for your help….

  2. #2
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    Apr 2007
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    Default

    I don't show 26 as a valid modifier for 94762.

    52 is a valid modifier but why are you wanting to reduce the charge? If someone else is doing the pulse ox and all your provider is doing is looking at the results you wouldn't get to bill for that. It may be included in data points on an E/M, though.

    Laura, CPC, CEMC

  3. #3
    Join Date
    Apr 2007
    Location
    Gulf to Bay Chapter in Clearwater Florida
    Posts
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    Default Overnight pulse oximetry test (CPT code 94762)

    I need to know were can I get written guidelines on CPT code 94762 using modifier 26 or 52.... The physician is only reading the result and in all research is recommended to charge for an E/M visit.....

    Thanks, for your help on this matter...

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