# SPIROMETRY, PULSE OX and demo



## kdriscoll (May 22, 2008)

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!


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## LOVE2CODE (May 22, 2008)

kdriscoll said:


> 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


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## heatherwinters (May 23, 2008)

*Maybe this article will help*

http://www.rcjournal.com/contents/08.03/08.03.0786.pdf


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## LOVE2CODE (May 23, 2008)

heatherwinters said:


> http://www.rcjournal.com/contents/08.03/08.03.0786.pdf




Thanks for this info....


YTH, CPC


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## kdriscoll (Jun 6, 2008)

Thank You!


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## heatherwinters (Jun 9, 2008)

*Pulse Oximetry*

*http://www.cignagovernmentservices.com/partb/help/faqs/general/faq_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


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## kdriscoll (Jun 10, 2008)

Heather, 

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


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