Results 1 to 6 of 6

use of modifier 59 on pulmonary procedures

  1. #1
    Default use of modifier 59 on pulmonary procedures
    Clearnace Sale
    use of 59 modifier on pulmonary procedures


    We have a situation in our Pedicatric doctors office verses our billing office. we bill a 94760 oxygen sat single with an E/M-25 only. our billing office have the system set up to edit the pulse oximetry to add the 59 modifier. i don't think i should be adding the 59 modifier on the first procedure line and it's the only procedure. our billing office says it's per the insurance guidelines, policies and from the appeals of denied claims to justify adding the 59 modifier. Should I be concern about this? Will this put our Pediactric office in jeopardy of an audit?

  2. #2
    Default pulmonary procedures
    I thought the 94760 was bundled into any other procedure OR E/M done on that day. Anyone else?

  3. #3
    North Carolina

    I agree with you. Most of our carriers bundle this with the E/M code. Below is a reference....
    Rebecca CPC, CPMA, CEMC

    Your click COUNTS...

    CLICK to give FREE mammograms!

  4. #4
    its bundled- i have never been paid for it. neither has anyone i know.

  5. Default
    I agree, we never got any payment for the pulse ox., but we did receive payment for the aerosol treatments, by using a 59.

  6. #6

    I thought since 2007 Pulse Ox is only payable when it is a Facility bill and not on Professional because it's a Technical Component only?


Similar Threads

  1. Pulmonary Procedures with E/M
    By bdye in forum E/M
    Replies: 0
    Last Post: 02-03-2014, 10:37 AM
  2. -25 Modifier on all E/M procedures
    By abs1821 in forum Chiropractic
    Replies: 5
    Last Post: 09-19-2013, 10:04 AM
  3. Modifier PT on all procedures (?)
    By plynn in forum Gastroenterology
    Replies: 4
    Last Post: 04-13-2011, 06:10 AM
  4. Using Modifier 59 on multiple procedures
    By kellipatterson in forum Modifiers
    Replies: 3
    Last Post: 01-13-2011, 11:31 PM
  5. use of 59 modifier on pulmonary procedures
    By butterflysmile in forum Dermatology
    Replies: 1
    Last Post: 10-20-2008, 08:36 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.