Pulse Oximetry: Identifying Its Applications, Coding, and Reimbursement

doi:10.1378/chest.07-3127

Chest

Volume 135, Issue 3, March 2009, Pages 838-841

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Although pulse oximetry is a widely accepted and frequently used tool, the reporting and reimbursement of the three related codes, 94760, 94761, and 94762, are often confusing. This commonly used noninvasive tool is a useful adjunct to medical care, but it is not always reimbursed separately. Sometimes referred to as the “fifth vital sign,” along with BP, heart rate, temperature, and respiration rate, pulse oximetry is used in a variety of health-care settings. Pulse oximetry is frequently a component of monitoring for other diagnostic studies and treatments commonly performed by pulmonologists, respiratory care practitioners, and other providers in many settings. Pulse oximetry is used to manage patients on long-term oxygen therapy and for the identification of patients with possible obstructive sleep apnea.

Section snippets

Purpose and Scope

Pulse oximetry is widely used as a noninvasive tool to estimate the patient's arterial oxygen saturation (Sao₂). Used for more than four decades, it often replaces an arterial blood gas study and yields a sufficient amount of information about a person's Sao₂. In addition, overnight pulse oximetry is used as an economical means to suggest sleep apnea.¹ Sometimes referred to as the “fifth vital sign,” along with BP, heart rate, temperature, and respiration rate, pulse oximetry is used in a

Conclusion

Although pulse oximetry is used in most health-care delivery settings, the reimbursement has been either combined with other procedures or reduced to minimal levels. These devices have become affordable so that today a pulse oximeter can be purchased for about the same price as a high-quality stethoscope. In spite of the minimal reimbursements or in most cases the lack of separate reimbursement, the clinical time spent for the procedure performance and documentation does not seem equitable.

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: The author has no conflicts of interest to disclose.

: Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

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Chest

Topics in Practice ManagementPulse Oximetry: Identifying Its Applications, Coding, and Reimbursement

Section snippets

Purpose and Scope

Conclusion

Chest

AARC Clinical Practice Guideline

Topics in Practice Management
Pulse Oximetry: Identifying Its Applications, Coding, and Reimbursement