Pulse Oximetry Interpretation

[GeneralVeers]

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I've heard that if you document a pulse oximetry interpretation in a clinically appropriate scenario (i.e. pneumonia) that you can bill $2 each time.

My group currently doesn't bill for this, but we asked our "billing guru" and he states that Medicare and most insurances don't pay for it anyway.

I want to know what you guys know from experience if you get reimbursed for this, as our "guru" has been wrong on a number of occasions.

 

[turtle md]

I have heard the same, so now am in the habit of saying either hypoxic or not hypoxic when I read the SpO2.

 

[Stitch]

We recently added a 'pulse ox' check box in the ED orders, and usually whenever a nurse puts someone on an oximeter, they come over and ask you to initial the box. This is a recent change for us, and I'm told it's so we can bill for it. I think it's hit and miss in terms of whether we get reimbursed, but they say something is better than nothing.

 

[Hercules]

My attendings at UAB pounded it into me for my dictations all throughout residency, so I continue to do it now. Some insurers won't pay for it but it takes very little for me to add "which is normal" to my dictation while reading the vitals. Medicare, Medicaid, and Tricare (all federally subsidized insurance programs) will not pay for pulse ox interpretations, but I know BCBS and several others in AL pay for it.

 

[docB]

I always heard it was more like $7 but only with some insurers. We have a line for it on our T sheets. It's got 3 elements like most other things, the number with +/- O2, the interpretation (normal, adaquate, hypoxic) and (recently added) the time.

 

[leviathan]

The medical bill for a family member of mine included a line for pulse oximetry and monitoring for X hours. I can't remember what the renumeration was exactly, but it was somewhere in the $10-20 range.

 

[Jeff698]

The medical bill for a family member of mine included a line for pulse oximetry and monitoring for X hours. I can't remember what the renumeration was exactly, but it was somewhere in the $10-20 range.

It would be interesting to know if the bill was for hospital charges or physician charges.

We use MedHost and it has the ability to document pulse ox interpretation. I do it, as well as ECG and monitor interpretation but don't think our coders bill for it.

Take care,
Jeff

 

[igcgnerd]

Former ED scribe/ billing guru here*
Yes it can be billed for. Will your group actualy collect? Who knows. lol
In order to bill you must state: % on what, interpretation, and any needed intervention such as:
Pulse ox 99% on RA, normal, no intervention needed.

Anybody have other billing ?'s, I'm your guy.
It pissed me off when we lost the infusion codes. Made my job easier not having to document "1L NSS infused over 2 hrs UMDS" a million times a day. Now that we lost that the big thing on billing is cardiac monitors interpretation. Anytime nursing staff puts it on and you look at it, make sure it is billed for. It should include a blurb as to why the patient was placed on one such as " Pt was placed on cardiac monitor to monitor any arrhythmia that may develop during ED course". Interpretation should look something like this to receive the full compensation "Normal sinus rhythm, normal rate, 80 BPM, no ST changes, no ectopy".