we bill cpt 94760 and/or 94761 - usually 94760 which is for pulse oximetry. in almost all instances of our denials the patient has come in and complained of shortness of breath and the dr ordered a pulse oximetry. 786.05 is a covered dx per the LCD but our denial is C0-B15 which is payment included in allowance for another procedure. they are saying it's included with the office call. the LCD is a little unclear to me whether it's covered under PART B or not or if it's only allowed in a hospital setting not a physican's office.
Does anyone know anything about this? what's covered, what's not? I have been transferred to a level 2 person @ medicare 2 days in a row and have been on hold for an hour and a half each time, any insight would be helpful at this point!
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