Pulmonology Coding Alert

Question: As part of an examination, our pulmonologist documented that he walked with the patient for about 500 feet and a flight of stairs. The patient's saturation remained at 94 percent on room air. Can I code anything in addition to the E/M service based on the documentation? Should I carve out the pulse oximetry?

California Subscriber

Answer: Because oxygen saturation was the only pulmonary value the physician assessed, the procedure should be described only by the CPT codes for pulse oximetry (94760-94761, depending on the number of determinations the pulmonologist performed).

If an E/M service (99201-99215 for outpatient or 99221-99233 for inpatient) was performed and reported on the same date as the pulse oximetry, however, you may only code the E/M service on the CMS 1500 form. The pulse oximetry is not separately reportable and/or payable when another service payable under the Physician Fee Schedule is reported on the same date.