Provider Alert – Pulse Oximetry – 94760
| Date: | April 4, 2018 |
| To: | Health Plan of San Joaquin (HPSJ) Practitioners and Providers |
| From: | HPSJ Claims Department |
| Subject: | Pulse Oximetry – 94760 |
| Business: | Medi-Cal |
We have identified a system error which unfortunately has been inappropriately paying physicians for CPT 94760. The error has now been fixed. A recovery request will be sent out to those providers effected.
Per Medi-Cal guidelines, under surg_m00o3.doc.
CPT-4 code 94760 (non-invasive ear or pulse oximetry for oxygen saturation; single determination) is reimbursable only to physicians when no other services are billed for the same recipient, by the same provider on the same date of service.
This is a good time for the reminder to always refer to the Medi-Cal Provider Manual for billing guidelines, at www.medi-cal.ca.gov.
If you have additional questions, please contact our Customer Service Department at 209-942-6320.