Forum - Questions & Answers
Modifier 25 for pulse oximetry
I have been informed that when billing an E&M with a pulse oximetry that I need to put a 25modifier on the pulse ox. (example 99214, 94760-25) The diagnosis is the same for both the office visit and pulse ox. Is this correct?
Pulse Ox
Pulse Ox can only be billed IF it is the only service performed, otherwise bundled into E/M. (Medicare)
pulse ox
It shouldn't require a modifier for commercial patients, but if your commercials require it, add the modifier to the E/M service.
A client recently ran a report and found that most commercials paid a few bucks for it. It is bundled per Medicare, so you'll never collect from them for that, and can't bill the patient. Most Medicaid programs will deny, I suspect.
94760
our practice we bill for the 99213-99214 with modifier 25 and add modifier 59 to procedure 94760