Pulmonology Coding Alert

Question: A pulmonologist performed remote physiologic monitoring of a 78-year-old patient’s pulse oximetry for 16 days. The report indicates the provider set up and instructed the patient on how to use the FDA-approved equipment, supplied the monitoring equipment, and received daily recordings.

What procedure codes will I assign for the procedure?

Maine Subscriber

Answer: You’ll assign 99453 (Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment) and 99454 (Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days) to report this remote physiologic monitoring (RPM) service.

To collect reimbursement for both 99453 and 99454, you’ll need to document that the pulmonologist provided the service to an established patient, that the provider monitored the pulse oximetry for 16 days, and the provider also interpreted the results of the monitoring, created a care plan, and discussed the plan with the patient.

Pulmonologists use pulse oximetry to assess the oxygen level in the patient’s blood, monitor the oxygen saturation in the blood during or after surgery to assess the efficacy of lung medicines, and to see if the patient can handle exercise or increased activity levels. With RPM, the physician can accurately gauge the oxygen saturation while the patient goes about their life.