# Billing for 94760 pulse oximetry



## maryperry

Can you bill 94760 with an E&M visit and do you need to use mod-25?
We have not been billing for 94760 but plan on starting.


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## Teresa Collins

It has been my experience that insurance companies do not reimburse separately for 94760 even when modifier 25 is used on the E/M.  They tend to bundle it with the E/M code.

I hope this helps!

Teresa Collins, CPC


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## abbyfraise

You can not bill 94760 with an office visit.  The insurance companies will deny because they consider it part of the constitutional.  We were at one time billing both and were ALWAYS denied the pulse ox.


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## hopepg

94760 is a Medicare status T code, which says :

There are RVUs and payment amounts for these services, but they are only paid if there are no other services payable under the physician fee schedule billed on the same date by the same provider. If any other services payable under the physician fee schedule are billed on the same date by the same provider, these services are bundled into the physician services for which payment is made.

Which basically means if the E/M is payable for the same DOS, then this 94760 code is not going to be.


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## Brandy0618

*Rules vs Right?*

So, if our Dr states she wants 94760 on the claim since they actually did it, even though it will it not get paid, what is RIGHT?  Thank you, Brandy


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## Pam Brooks

Billing the 94760 with an E&M could be considered 'unbundling'.  I'd leave it off the claim.


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## Brandy0618

Thank you so much Pam...I appreciate you taking the time to help me!  God Bless, Brandy, CPC


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## MarcusM

Pulse oximeter charges used to be paid, back when the equipment was expensive. Advise your doctor that now a pulse ox is similar to taking a blood pressure reading, and you don't charge separate for that tool. The pulse ox is part of the diagnostics that aids in medical decision making, complexity, and the lower the pulse ox reading, then the more complicated the medical decision making. So it is fair to be part of the E & M CPT, just make  sure the documentation supports the level of coding.


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## Brandy0618

*Thank u*

Thank you for taking your time to respond to my question?  You pointed out some great points!!  Im never disappointed when I post my questions here....you guys ALWAYS DELIVER!!  Thank you so much!


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## deboracontos@yahoo.com

*94760 for vitals*

Should CPT  codes 94760, A4670 AND 2010F be used for taking vitals? (this is for ER department coding

Thank you,
Debbie


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## JuarezD

*resouces*

Hello,

Do you have any resources where I can find this information in writing?


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