Pulmonology Coding Alert

Question:

Indiana Subscriber

No CPT^® code represents the administration of oxygen therapy. Don't report 94799 (Unlisted pulmonary service or procedure), because you must bill oxygen in measurable units (i.e., per liter, per hour). You would include this in your E/M service. Should the patient require home oxygen, the physician must certify the need for this, after meeting certain requirements (available in Chapter 20 of the Medicare Claims Processing Manual, http://www.cms.gov/manuals/downloads/clm104c20.pdf).

Coverage: As long as you appropriately document the need for oxygen therapy, Medicare will likely cover this service. Make sure you submit a physician's written order for the oxygen, stating the device and/or specific flow rate or concentration of oxygen preferred. The order must also include time limits, and indicate reasons for beginning and ending the therapy.