Cardiology Coding Alert

Question: Medicare has been requesting payment back for our 93284 services stating we can't report both professional and technical components. What's the correct way to report this?

New Jersey Subscriber

Answer: The code you mention is 93284 (Programming device evaluation [in person] with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous implantable defibrillator system).

Medicare splits this code into professional and technical components, so if you're reporting only the cardiologist's work (such as when the service is performed in a hospital), then you should append modifier 26 (Professional component).

Don't miss: You also need to consider whether a device representative was involved in the check because you cannot bill Medicare for the rep's services or equipment. It's appropriate to bill only for employed staff covered under your Tax ID. Keep this in mind for these codes, as well:

• 93287, Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system
• 93289, Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including analysis of heart rhythm derived data elements.