Pediatric Coding Alert

Question: A pediatrician administers oxygen to an office patient who has a severe asthma attack. How should I code the oxygen administration?

Pennsylvania Subscriber

Answer: You should consider the oxygen administration included in the E/M service, such as 99215 (Office or other outpatient visit for the evaluation and management of an established patient ...). CPT contains no code for the oxygen treatment.

Make sure to link the office visit to an asthma exacerbation (such as 493.02, Asthma; extrinsic asthma; with [acute] exacerbation). A fifth digit subclassification of "2" indicates the medical necessity for the extensive services and procedures that asthma crisis treatment cases involve.
 
You should, however, bill for the pulse oximetry (such as 94760, Noninvasive ear or pulse oximetry for oxygen saturation; single determination) that you use to measure the patient's oxygen level. Most payers will follow Medicare's policy and bundle the pulse ox into the E/M service, but some payers do separately reimburse for pulse oximetry. By billing for 94760, you also establish that you provide the service.