How To Use CPT Code 94761

CPT 94761 describes the noninvasive ear or pulse oximetry procedure for multiple determinations of a patient’s oxygen saturation. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 94761?

CPT 94761 is used to describe the noninvasive ear or pulse oximetry procedure for multiple determinations of a patient’s oxygen saturation. During this procedure, a sensor is placed on the patient’s earlobe or fingertip to measure the oxygen saturation by detecting the differences in the ways blood cells with and without oxygen reflect light. The sensor transmits the data to a computer unit that displays the result. This code is used when the provider takes multiple measurements of the patient’s oxygen saturation.

2. Official Description

The official description of CPT code 94761 is: ‘Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise).’ It is important to note that this code should not be reported in conjunction with CPT codes 94617, 94618, 94619, or 94621.

3. Procedure

1. The provider places a sensor, such as one in the form of a clip, on the patient’s earlobe or fingertip.
2. The sensor uses a light shining through the body part to measure the oxygen saturation.
3. The sensor detects the differences in the ways blood cells with and without oxygen reflect light.
4. The data is transmitted to a computer unit that displays the result.
5. The provider takes multiple measurements of the patient’s oxygen saturation.

4. Qualifying circumstances

CPT 94761 is typically performed on patients who require multiple determinations of their oxygen saturation. This procedure is commonly used during exercise or in situations where frequent monitoring of oxygen saturation is necessary. It is important to review the specific circumstances and indications for this procedure to ensure accurate reporting.

5. When to use CPT code 94761

CPT code 94761 should be used when the provider performs noninvasive ear or pulse oximetry for multiple determinations of a patient’s oxygen saturation. This code is appropriate when the provider takes multiple measurements during the procedure. It is important to review the specific documentation requirements and guidelines for accurate reporting.

6. Documentation requirements

To support a claim for CPT code 94761, the provider must document the following information:

• Reason for performing the noninvasive ear or pulse oximetry procedure
• Number of measurements taken during the procedure
• Date and time of the procedure
• Results of the oxygen saturation measurements
• Any additional relevant information or observations

7. Billing guidelines

When billing for CPT code 94761, it is important to ensure that the procedure meets the specific criteria outlined in the code description. Providers should review the guidelines and requirements set forth by their payers to ensure accurate and appropriate billing. Additionally, it is important to be aware of any bundling policies that may apply to pulse oximetry services. Checking the payer’s policy is crucial to determine if pulse oximetry is bundled into other services.

8. Historical information

CPT code 94761 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoing a stress test requires multiple determinations of their oxygen saturation using noninvasive ear or pulse oximetry.
2. A patient with a respiratory condition is monitored during exercise to assess their oxygen saturation levels using noninvasive ear or pulse oximetry.
3. A patient with a chronic illness requires frequent monitoring of their oxygen saturation throughout the day using noninvasive ear or pulse oximetry.
4. A patient recovering from surgery needs continuous recording of their oxygen saturation using noninvasive ear or pulse oximetry.
5. A patient with a sleep disorder undergoes overnight monitoring of their oxygen saturation using noninvasive ear or pulse oximetry.
6. A patient with a cardiac condition requires monitoring of their oxygen saturation during rest and exercise using noninvasive ear or pulse oximetry.
7. A patient with a respiratory infection needs multiple determinations of their oxygen saturation using noninvasive ear or pulse oximetry.
8. A patient with a chronic lung disease undergoes continuous recording of their oxygen saturation using noninvasive ear or pulse oximetry.
9. A patient with a heart condition requires overnight monitoring of their oxygen saturation using noninvasive ear or pulse oximetry.
10. A patient with a sleep disorder needs monitoring of their oxygen saturation during sleep using noninvasive ear or pulse oximetry.