Pulmonology Coding Alert

Question: Can an exercise oximetry code be billed with a physical therapy code?

Oklahoma Subscriber  
Answer: Exercise oximetry (94761, noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations [e.g., during exercise]) will most likely be denied when billed with another service. Code 94761 has a status indicator of "T," which means it cannot be billed with another code for the same encounter. Addendum B of the Federal Register, which lists the physician fee schedule, contains the status indicator of each code. According to the Nov. 1, 2000, Federal Register, procedures and services with a "T" status "are only paid if there are no other procedure/services payable under the physician fee schedule billed on the same date by the same provider. If any other procedures/services payable under the physician fee schedule are billed on the same date by the same provider, these ('T' status) services are bundled into the service(s) for which payment is made."
 
In this case, 94761 is bundled into 97150 (therapeutic procedure[s], group [two or more individuals]). Bill only 97150. If you report the 94761 with it, you will not be paid for the visit, and you run the risk of making the patient pay for the extra service. Most commercial carriers follow this Medicare rule, but always check with your carrier.