How To Use CPT Code 94760

CPT 94760 refers to a single determination of noninvasive ear or pulse oximetry for oxygen saturation. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 94760.

1. What is CPT 94760?

CPT 94760 is a medical billing code used to describe a single determination of noninvasive ear or pulse oximetry for oxygen saturation. This procedure measures the percentage of hemoglobin carrying oxygen molecules in a patient’s blood using a sensor placed on the earlobe or fingertip. The code is used by medical coders and billers to accurately document and bill for this specific service.

2. 94760 CPT code description

The official description of CPT code 94760 is: “Noninvasive ear or pulse oximetry for oxygen saturation; single determination.”

3. Procedure

The 94760 procedure involves the following steps:

1. The provider selects an appropriate sensor, such as a clip, to be placed on the patient’s earlobe or fingertip.
2. The sensor is attached to the patient’s earlobe or fingertip, ensuring proper placement and contact.
3. The sensor uses a light to shine through the body part, measuring the oxygen saturation by detecting differences in the way blood cells with and without oxygen reflect light.
4. The sensor transmits the data to a computer unit that displays the result as a percentage of hemoglobin carrying oxygen molecules.
5. The provider records the single measurement of oxygen saturation for documentation and billing purposes.

4. Qualifying circumstances

Patients eligible to receive CPT code 94760 services are those who require a single determination of oxygen saturation for various reasons, such as:

• Monitoring oxygen levels during a medical procedure or treatment
• Evaluating the effectiveness of oxygen therapy
• Assessing a patient’s respiratory status
• Diagnosing or monitoring certain medical conditions, such as chronic obstructive pulmonary disease (COPD), asthma, or sleep apnea

5. When to use CPT code 94760

It is appropriate to bill the 94760 CPT code when a single determination of noninvasive ear or pulse oximetry for oxygen saturation is performed. This code should not be used for multiple or continuous measurements, as there are separate codes for those services (CPT 94761 and 94762).

6. Documentation requirements

To support a claim for CPT 94760, the following information should be documented:

• The patient’s medical history and reason for the oxygen saturation measurement
• A description of the procedure, including the type of sensor used and its placement on the patient’s body
• The single oxygen saturation measurement result, expressed as a percentage
• Any relevant clinical findings or observations related to the patient’s oxygen saturation
• The provider’s interpretation of the results and any recommendations for further evaluation or treatment

7. Billing guidelines

When billing for CPT code 94760, it is important to follow payer-specific guidelines and rules. Some payers may bundle pulse oximetry into other services, so it is crucial to verify the payer’s policy before submitting a claim. Additionally, ensure that the appropriate code is selected based on the number of measurements taken (94760 for a single determination, 94761 for multiple determinations, and 94762 for continuous monitoring).

8. Historical information

CPT 94760 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 94760

Five similar codes to CPT 94760 and how they differentiate are:

• CPT 94761: This code is used for multiple determinations of noninvasive ear or pulse oximetry for oxygen saturation, rather than a single determination.
• CPT 94762: This code is used for continuous monitoring of noninvasive ear or pulse oximetry for oxygen saturation, rather than a single determination.
• CPT 82803: This code is used for blood gas analysis, which measures oxygen and carbon dioxide levels in the blood, rather than noninvasive oximetry.
• CPT 82805: This code is used for blood gas analysis with oxygen saturation, which includes both blood gas measurements and oxygen saturation, rather than noninvasive oximetry alone.
• CPT 82810: This code is used for blood gas analysis for carbon dioxide only, rather than noninvasive oximetry for oxygen saturation.

10. Examples

Here are 10 detailed examples of CPT code 94760 procedures:

1. A patient with COPD requires a single determination of oxygen saturation to assess their respiratory status during a routine office visit.
2. A patient undergoing a minor surgical procedure requires a single determination of oxygen saturation to ensure adequate oxygen levels during the procedure.
3. A patient with asthma experiences shortness of breath and requires a single determination of oxygen saturation to evaluate the severity of the episode.
4. A patient receiving oxygen therapy for a respiratory condition requires a single determination of oxygen saturation to assess the effectiveness of the treatment.
5. A patient with sleep apnea undergoes a single determination of oxygen saturation during a sleep study to evaluate their oxygen levels during sleep.
6. A patient experiencing chest pain requires a single determination of oxygen saturation to rule out hypoxia as a contributing factor.
7. A patient with pneumonia requires a single determination of oxygen saturation to monitor their respiratory status and response to treatment.
8. A patient undergoing a stress test requires a single determination of oxygen saturation to ensure adequate oxygen levels during the test.
9. A patient with a history of heart failure requires a single determination of oxygen saturation to assess their oxygen levels during a routine office visit.
10. A patient with a suspected pulmonary embolism requires a single determination of oxygen saturation to evaluate their oxygen levels and assist in diagnosis.