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94761 vs 94620

  1. Default 94761 vs 94620
    Medical Coding Books
    If a patient is seen in the clinic for a 6 min walk w/ oxgyen w/ pulse ox which code is appropriate...94761 or 94620? There is some confusion and hopefully someone who is an expert in pulmonary or who code these frequently can help.


  2. #2
    I would say 94761... 94620 says it includes a pre and post spirometry
    Herbie W Lorona Jr., CPC, CPC-H

  3. Default
    Do you have a Coder's Desk Reference? If you read the description it states: A pulmonary stress test is performed to test how much air moves in and out of the lungs during exercies and to determine where breathing problems are occurring, since it may be in the lungs, heart, or circulation. It then goes on to state how the test is done...Involving a stationary bike, or treadmill and measuring heart rate, breathing and blood pressure. A spirometry is also done as mentioned before.

    So you should compare that to your documentation. If they just walked the patient down the hall or something and just did a pulse ox, you could code for the pulse ox and an E/M, again if the documentation supports this, if not just the pulse ox. Also, 94761 is for multiple measurements, so was this done multiple times or just once. One measurement would be 94760. Not all payors will pay for a pulse ox with an E/M...Medicare/Medicaid for example. So you may only be able to charge for an E/M, if there is documentation for this.

  4. Default
    94761 Would Be The Code To Use Generally They Are Going To Get Pulse Ox Before Exercise And Then During Exercise.

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