Q&A: Billing for pulse oximetry

Wednesday, April 12, 2023

Q: For patients in the emergency department (ED) who present with a pulmonary concern, would a pulse oximetry reading performed after the initial intake reading be considered separately billable?

A: It depends. If the physician/practitioner orders pulse oximetry readings at intervals for a patient, and they document how they used this information to make care decisions, an argument can be made for billing separately. It can be difficult in the ED because pulse oximetry has become a part of routine vital sign monitoring. Therefore, the documentation doesn't always support the use of the information for specific decision making. If there is an order to titrate the oxygen level based on the patient's oximetry at certain intervals, the physician/practitioner still needs to acknowledge that they reviewed the information.

Editor’s note: This question was posted on the NAHRI Forums. Opinions expressed are those of the authors and do not necessarily represent those of NAHRI, HCPro, or any of its subsidiaries. Find more NAHRI resources on billing and claims here.