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Pulse Ox in the ED

  1. Post Pulse Ox in the ED
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    I am currently working on a build team to help our hospital go to Electronic Medical Records. Over the past 3 years, I have been working diligently to capture errors by poor documentation, over billing, etc. Lately we have been discussing Pulse Oximetry and how it is billed. My questions are as follows:

    a. Is a single PO included with the ED Care Level (E/M)? Basically what I am asking here is if you have a Pt come in with SOB and the Triage RN performs a PO on them in you bill for a single or include that with you E/M?
    b. How do you determine MULTIPLE POs? Someone told me that anything over 1 is considered to be multiple however I can't find any documentation to support this.
    c. Must the Dr write/order for ALL POs whether it be single, multiple or continuous?
    d. Do you get reimbursed for these charges?

    Any help offered would be greatly appreciated! Thank you in advance.

  2. Default PO
    If you are talking physician coding, PO is seldom coded spearately. Medicare does not recognize a profesional compnent. I believe it is also generally wrapped in on the facility side as well. There are a few payors who will pay so of course some billers will bill it. But generally viewed as wrapped into the level.


  3. #3
    Default Pulse Ox in the ED
    I code ED for my facility. We code for Pulse Ox (only once) as long as the Physician orders it, and we do not include it in the level. I believe that some payors pay for it while others do not, but we code it whenever it is ordered.

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