2025 CPT code 94762
(Active) Effective Date: N/A Revision Date: N/A Diagnostic - Pulmonary Function Studies Medicine Services and Procedures > Pulmonary Procedures Feed
Noninvasive ear or pulse oximetry for oxygen saturation; continuous overnight monitoring (separate procedure).
Modifier -26 (professional component) may be appended if the physician is not the one performing the procedure.Modifiers should be carefully reviewed based on the clinical circumstances and payer guidelines.
Medical necessity for 94762 is established when there is a clinical indication to monitor oxygen saturation levels overnight. This is particularly relevant for patients with suspected or known sleep-disordered breathing, COPD, or other conditions affecting oxygenation. The results of the test must be used to guide clinical decision-making regarding treatment and management.
The provider is responsible for applying the sensor, monitoring the data transmitted from the sensor, and interpreting the results to assess the patient's oxygen saturation levels during sleep.The physician's role is to order the test, review the results and integrate them with the overall assessment of the patient's condition.Further action, if indicated by the results, will be undertaken by the physician.
In simple words: This test measures the amount of oxygen in your blood while you sleep. A small sensor is placed on your ear or finger to track oxygen levels throughout the night.The results help doctors assess how well your body is getting oxygen.
This CPT code, 94762, represents noninvasive ear or pulse oximetry for continuous overnight monitoring of oxygen saturation.It's a separate procedure, indicating that it should not be reported when performed as an integral part of a larger procedure. The procedure involves placing a sensor on the patient's earlobe or fingertip to continuously monitor oxygen saturation levels throughout the night. The sensor uses light to measure the oxygen saturation by detecting the differences in how oxygenated and deoxygenated blood cells reflect light. This data is transmitted to a computer for display.
Example 1: A patient with suspected sleep apnea undergoes continuous overnight pulse oximetry (94762) to monitor oxygen desaturation events during sleep. This helps determine the severity of the apnea and guide treatment decisions., A patient with chronic obstructive pulmonary disease (COPD) is monitored overnight using 94762 to assess the effectiveness of their treatment regimen.The overnight oximetry data provides information on nighttime hypoxemia., A patient presents to the emergency department with shortness of breath.Continuous overnight pulse oximetry is ordered (94762) to monitor oxygen saturation and guide management decisions. This is an example where the code might be used in a setting other than outpatient.
* Detailed clinical indication for the pulse oximetry study, including the patient's symptoms and relevant medical history.* Specific type of device used.* Precise start and end times of the continuous overnight monitoring.* All recorded oxygen saturation values with any relevant trends and patterns.* Physician interpretation of the results, including any significant findings and their clinical implications.* Physician's plan for further management based on the test results.
** This code is used for continuous overnight monitoring. Shorter periods of monitoring should be coded using 94760 or 94761, depending on the specific scenario.Proper documentation is crucial for accurate coding and reimbursement.
- Revenue Code: T2D (OTHER TESTS - OTHER)
- RVU: Information not available. RVUs vary based on geographic location, payer, and other factors.
- Global Days: Not applicable. This is a diagnostic procedure, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to this code because it doesn't usually involve a technical element that is separately billable. The physician’s role in this procedure is primarily professional.
- Fee Schedule: Information not available. Fee schedules vary by payer and location.
- Specialties:Pulmonology, Sleep Medicine, Cardiology, Critical Care Medicine, Emergency Medicine
- Place of Service:Office, Hospital (Inpatient and Outpatient), Emergency Room, Ambulatory Surgical Center, Home Healthcare