93000 Coding

ashleym

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Our office has always coded our EKG as a 93000, we do the ekg and interpretation always on the same day. However, UHC recently sent back an eob and they changed the 93000 to a 93005 and 93010. Has anyone else run into this? It confuses me because if a 93010 and 93005 are on the same claim it is a 93000, just as we billed. Please help!
 

cmcguire@acmdocs.com

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Alpharetta, GA
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93000

That is correct you should be billing 93000 and UHC is doing the same to us. I am not sure the reason and I have contacted UHC and they have not been able to give me an answer as to why they are doing this.
Cindy McGuire, CPC
 

bhullett

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Albany, GA
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any response from UHC?

Has anyone been able to get a response from UHC re: why they are changing 93000 to 93005 and 93010? It hasn't really caused an issue for us until now. We have secondary payers who are not paying the claims bc the charges do not match.
-:confused:Brooke Hullett CPC
 

Codergirl93

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Sturtevant, WI
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How we code for the EKG is 93010 as the professional portion and 93005 as the tech portion. That is how we have always coded it and never had any issues with any insurance company including UHC. The reason we do it that way is because we are a hospital based group practice. So when we do an EKG on a patient we are in away "borrowing" the EKG equipment from the hospital so that is where 93005 comes into play, seeing how the hospital needs to be paid as well. Than our providers get 93010 because they interp and reported on the EKG. Now I realize every place is different but maybe that is how UHC is looking at it now.
 
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Westford, MA
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93000 and/or 93040

Is there ever a situation that both can be billed? If the provider did the EKG then based on those results did the rhythm is it appropriate to use both 93000 and 93040 with mod 59 on the 93040?

Thanks!!
 

ashleym

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Has anyone been able to get a response from UHC re: why they are changing 93000 to 93005 and 93010? It hasn't really caused an issue for us until now. We have secondary payers who are not paying the claims bc the charges do not match.
-:confused:Brooke Hullett CPC

When I called they said they changed it for "more appropriate coding". The rep also forwarded it for further explanation but all I got back was a letter stating the claim was processed correctly. :( I just dont understand how all of a sudden they're changing them when they had no issue before.
 
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