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Thread: codes 94060 and 94760

  1. #1
    Join Date
    Apr 2007
    Posts
    17

    Wink codes 94060 and 94760

    Can I bill both these codes together, do I need a Modifier?

    I would really apreciate your help.

    Thank you,

    Linda

  2. #2
    Join Date
    Apr 2007
    Location
    Chicopee, MA
    Posts
    108

    Default

    You can bill them together. They are not bundled per CCI, but the different payors may have their own guidelines. If I remember correctly, many payors do not reimburse 94760 when done with any other services on the same day.

    Erica

  3. #3

    Default

    These are the following limitations for 94760 for GHI Medicare. I'm not sure which payor you are inquiring about. They usually have their own rules but most adhere to these guidelines.

    1. Routine testing (in the absence of signs or symptoms suggestive of desaturation) is not covered.
    2. Continuous overnight monitoring in the home is covered only when the results are reliable in that setting.
    The patient’s record must document that the oximeter is present and self-sealed and cannot be adjusted by the
    patient. In addition, the device must provide a printout which documents an adequate number of sampling
    hours, per cent of oxygen saturation and an aggregate of the results. This information must be available, if
    requested.
    3. In all instances, there must be a request documented in the medical record from a physician for these
    services.
    4. When pulse oximetry for oxygen saturation is utilized to monitor a patient’s respiratory status/oxygen
    saturation during a surgical procedure, endoscopy, cardiac or pulmonary rehabilitation, oximetry is
    considered included in the primary service and not separately reimbursable.
    Desiree Balladin CPC, CCS-P, PCA
    Billing Manager
    http://www.dmedbilling.com/

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