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SPIROMETRY, PULSE OX and demo

  1. Arrow SPIROMETRY, PULSE OX and demo
    Medical Coding Books
    We are having trouble consistenely getting CPT 94010, 94664 and 94760 paid whether we use a modifier(s) or not. What is the best/correct way to get these three reimbursed?
    Any advise someone can offer would be GREATLY appreciated!
    Last edited by kdriscoll; 05-22-2008 at 02:43 PM.

  2. #2
    Smile
    Quote Originally Posted by kdriscoll View Post
    We are having trouble consistenely getting CPT 94010, 94664 and 94760 paid whether we use a modifier(s) or not. What is the best/correct way to get these three reimbursed?
    Any advise someone can offer would be GREATLY appreciated!
    I have no success either in getting the above codes paid....Insurance co's states it is included in the E/M code...


    YTH, CPC

  3. #3

  4. #4
    Thumbs up
    Quote Originally Posted by heatherwinters View Post

    Thanks for this info....


    YTH, CPC

  5. Default
    Thank You!

  6. #6
    Default Pulse Oximetry
    http://www.cignagovernmentservices.c..._07_25_07.html



    Q2. I'm trying to bill a claim for an office visit and pulse oximetry (94761), why is my charge for the pulse oximetry being denied?

    A2. Effective for services on and after January 1, 2000, the Centers for Medicare & Medicaid Services (CMS) changed the status for code 94761 from "A" (active) to "T" (injection). This means that although this code is not performed as an injection, the relative value units fall under the same category as some injection procedures. Code 94761 is only paid if there are no other services, payable under the physician fee schedule, billed on the same date, by the same provider. If an office visit was billed and allowed for payment, then payment cannot be made for code 94761. This service would be bundled into the office visit.
    The pulse oximetry LCD (Local Coverage Determination) can be found at the following link: http://www.cms.hhs.gov/mcd/viewlcd.asp?lcd_id=6465&lcd_version=16&show=all
    Heather Winters, CPC, CFPC

  7. Talking
    Heather,

    Thank you SO much for information and your time! I really appreciate your help!

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