Forum - Questions & Answers

Jan 20th, 2010 - schasse 4 

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?

Jan 20th, 2010 - nmaguire   2,606 

Pulse Ox

Pulse Ox can only be billed IF it is the only service performed, otherwise bundled into E/M. (Medicare)

Jan 24th, 2010 - Codapedia Editor 1,399 

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.

Mar 9th, 2010 -

94760

our practice we bill for the 99213-99214 with modifier 25 and add modifier 59 to procedure 94760



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