Medical Billing Questions – Is Oxygen a Separate Code?
Medical Billing Questions – Is Oxygen a Separate Code?
If you’re having trouble finding an oxygen administration coding in the CPT, the reason is that there is no specific oxygen administration codings for your medical billing. When a patient requires oxygen, the use of the oxygen is bundled into the day’s EM services.
When a doctor prescribes the oxygen, you should use the appropriate office visit code that describes the procedure and services performed by the physicians that necessitates the need for oxygen. Full documentation of the medical billing claim will insure that your bundled oxygen administrations codings get full reimbursement.
For example, if you have a physician who performs a detailed examination and incurs moderate complexity decision making before administering oxygen to a known patient who is having a possible reaction to an injection you will want to use 99214 (Office or other outpatient visit for the evaluation and management of an established patient…), as well as any additional procedures and special services.
Outsourcing your medical billing can eliminate a lot of the “when do I use …” headaches a lot of members of your staff may be having. The CPT changes frequently and in many cases codes are deleted or changed and not keeping up the changes can cost you in the most literal sense of the word. If you have frequent partial payments or rejected claims, it is probably either due to low medical documentation (not enough documentation to pay the claim) or using the incorrect CPT code. A code that was correct for a procedure one year ago may have been modified this year and will no longer exactly fit the bill.
Your outsource medical billing partner will keep up with these changes so you don’t have to and you are always to be sure to get the maximum reimbursement on your medical billing claims.
What’s the correct code to bill for clients that have had oxygen prescribed but have changed company who fills the prescription? We are the new company that fills the prescription and we are not being paid for what we have already filled.
Now this makes some assumptions on my part, but the code itself wouldn’t be changing simply because the supplier changed.
Whether it’s prescribed for COPD, shortness of breath, etc, the code stays the same and it’s normally covered by Medicare. As far as what code? It depends on the diagnosis given by the prescribing physician.
I would investigate it more if I were you, especially original DX, but it sounds like the diagnosis itself might be the problem if it’s being denied.
If it turns out to be the DX causing it, go back to the original prescribing physician.