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ED billing / Pulse Ox

  1. #1
    Default ED billing / Pulse Ox
    Medical Coding Books
    Hey there ED coders,

    I got a bill from the ED MD and wanted to find out if it's correct.

    99284, 93010, 94760

    I'm asking because I thought the 94760 was bundled into 99284 and my insurance refuses to pay that charge (94760), so they are passing 100% of it on to me.

    My diagnosis was 458.0, 780.2

    Thanks for any help in advance!
    Heidi Thompson, CPC

  2. #2
    Default Pox
    We do not charge out Pulse Ox by our physican group, almost all carriers bundle it, it is done routinely by nursing staff, much like vitals. I would dispute that charge with the billing group
    Good Luck

  3. #3
    Default
    Quote Originally Posted by hthompson View Post
    Hey there ED coders,

    I got a bill from the ED MD and wanted to find out if it's correct.

    99284, 93010, 94760

    I'm asking because I thought the 94760 was bundled into 99284 and my insurance refuses to pay that charge (94760), so they are passing 100% of it on to me.

    My diagnosis was 458.0, 780.2

    Thanks for any help in advance!
    That looks god to me. That is how our ER bills for it. I would question the payer.

  4. #4
    Default
    Now I have 2 conflicting answers. Can I have some more feedback on why it would or wouldn't be bundled into the ER visit? Also, if it's vitals, why would it be on the physician billing and not the facility charge?

    At my clinic, we only bill the 94760 pulse ox when it's done specifically for a condition that it might drop or if they had a neb tx or it was rechecked later in the visit to see if the number improved.

    The billing service is supposed to return my call today, so if you have an answer, please speak up
    Heidi Thompson, CPC

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