# Pulse OX



## dballard2004 (Apr 27, 2009)

Is pulse oximetry no longer reimbursed by Medicare?   I was taught it is considered a 5th Vital sign.   My private practice certified coder informed me of this in 2007.  
Secondly, If pulse oximetry is billed with a URI or sinusitis ICD-9, is that a problem. Shouldn't it only be billed with a pulmonary code e.g.: Cough, Bronchitis or Asthma


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## melaapc04 (Apr 27, 2009)

Pulse ox is considered incidental by Medicare when billed with the E/M service. It is because it is a part of the vitals being taken during the visit (or, as you mentioned, it is called the "5th vital"). Hope this helps. If you need a reference, I just finished reading an article at www.chestjournal.org in the march issue about this.


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## RebeccaWoodward* (Apr 27, 2009)

Also....(NC)

http://www.cms.hhs.gov/mcd/viewlcd.asp?lcd_id=6465&lcd_version=19&show=all


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## dballard2004 (Apr 27, 2009)

Thanks so much!


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## lisigirl (Apr 27, 2009)

At our facility we count pulse ox under "data reviewed" when determining MDM. You can't bill separately for pulse ox but it is a test from the medicine section of CPT that our physician is reviewing so we count the work.

Lisi, CPC


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