tci E/M Coding Alert - 2016 Issue 12

Reader Question: Careful When Coding Oximetry Separately From E/M

Question: We are coding an office E/M code for a patient along with a single-reading pulse oximetry, and the payer is denying the service as bundled. I checked the Correct Coding Initiative (CCI), but could find no edits for office E/M codes and pulse oximetry code 94760. We have also submitted the claim with modifier 25 on the E/M and modifier 59 on 94760, with no success. How should I be coding this claim? Washington Subscriber Answer: If the physician performed the E/M and the oximetry on the same date of service, you won’t be able to unbundle...

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