Respiratory Question for the Week of January 16, 2023

Question:

Do you have any tips for billing for an oximetry trend study?

Answer:

It is appropriate to bill for CPT codes, which have been assigned an “N” status indicator; however, the facility will not receive additional reimbursement from Medicare. Procedures that have been classified as “incidental” will be “packaged” to the significant procedure. In the case of pulse oximetry, codes 94760 and 94761, the procedures will not pass the billing edit when there is no other procedure performed on the same date of service in the outpatient setting. Remember: CPT code 94762 is reimbursed under a composite APC if composite-specific criteria are met, or separately under APC 5721 if not. The 2023 APC reimbursement rate for 94762 is $145.43.