2025 CPT code 94761
(Active) Effective Date: N/A Revision Date: N/A Pulmonary Function Tests - Noninvasive ear or pulse oximetry Medicine Services and Procedures > Pulmonary Procedures Feed
Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (e.g., during exercise).
Modifiers may be applicable depending on the circumstances of service. Consult your payer's guidelines for appropriate modifier usage.
Medical necessity for pulse oximetry is established when there is a clinical indication for assessment of oxygen saturation levels. This could include evaluation of respiratory function, monitoring during exercise or sleep studies, or assessment of the efficacy of respiratory therapy. The physician's documentation should clearly support the medical need for the procedure based on the patient's presentation and clinical findings.
The provider is responsible for placing the sensor, monitoring the readings, and interpreting the results. This involves understanding the technology used, recognizing potential artifacts, and correlating the data with the patient's clinical status.
In simple words: The doctor uses a small sensor on your ear or finger to take several measurements of your blood's oxygen level. This is usually done during activities like exercising to see how your oxygen levels change.
This CPT code, 94761, represents the performance of noninvasive ear or pulse oximetry to measure oxygen saturation in the blood.The procedure involves multiple determinations of oxygen saturation levels, often used to monitor changes during activities such as exercise. The provider attaches a sensor to the patient's earlobe or fingertip; this sensor uses light to measure oxygen levels in the blood and transmits the data to a computer for display. This code is specifically for multiple measurements.
Example 1: A patient with suspected pulmonary hypertension undergoes exercise testing with pulse oximetry to monitor oxygen saturation during exertion., A patient with chronic obstructive pulmonary disease (COPD) has serial pulse oximetry measurements taken during a pulmonary rehabilitation program to assess response to therapy., During a sleep study, multiple pulse oximetry measurements are taken to evaluate oxygen desaturation events associated with sleep apnea.
The patient's medical record must document the reason for the test, the date and time of the procedure, the number of measurements taken, the specific locations of the sensor placement, and the results obtained.The method of measurement (ear or finger) should be specified.Any significant findings or deviations should be noted, and relevant clinical context should be provided.
** Many payers bundle pulse oximetry into other services. Always check your payer's policy to determine appropriate billing practices.Accurate documentation is essential to support medical necessity and appropriate reimbursement.
- Revenue Code: T2D (OTHER TESTS - OTHER)
- RVU: This information is not available in the provided text.RVUs vary based on geographic location and other factors. Consult your local Medicare Administrative Contractor (MAC) for current RVU values.
- Global Days: Not applicable. This is not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is not a procedure with a technical component.
- Fee Schedule: This information is not provided. Fee schedules vary by payer and geographic location. Consult fee schedules for specific payers.
- Specialties:Pulmonology, Cardiology, Sleep Medicine, Critical Care Medicine
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgical Center, Emergency Room, Skilled Nursing Facility