Wiki 93320,93325,93350 denied

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It depends. What was the denial code from the insurance company? There could be many factors for the denial. Were these codes billed with other codes that would include them; what insurance does this patient have; Is this service covered by the patient's insurance; Was prior auth required and if so was it obtained; If this is a medicare patient, was the LCD looked at? All of these factors need to be looked at. Based on your post I don't think that anyone can really give you an answer, more information is needed.
 
93016, 93018, 93320, 93325, 93350 were billed together, only 93016 & 93018 were paid & it was a private insurance.
 
Since I don't have the report I can't tell you exactly how it should have been billed, but from the information you have given it looks like this was coded incorrectly. If the physician supervised the stress echo and did the interpretation code 93351 should have been used with the add on codes 93320 & 93325.
 
dclark7 said:
Since I don't have the report I can't tell you exactly how it should have been billed, but from the information you have given it looks like this was coded incorrectly. If the physician supervised the stress echo and did the interpretation code 93351 should have been used with the add on codes 93320 & 93325.
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I disagree and think it was coded correctly. If the stress echo was done in the hospital and it WASN'T the physician's equipment then the 93016/93018 being billed with 93350-26 and 93320-26/93325-26 (if documented) was correct.

Jessica CPC, CCC
 
I also disagree, when our physician is doing a stress interp, and reads the stress report for the images, AND the written report, we then code 93350-26-I and 93016 & 93018. We do not use the 93320 & 93325 because they are part of that stress code so you would be billing twice! 93350 includes the echo and the stress, no need to use anything other than 93350, 93016 and 93018 for stress interp
 
Cpt 93350

93350 - Echocardiography, transthoracic, real-time with image documentation (2D), inlcudes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report.

Stress testing codes 93016-93018 should be reported, when appropriate, in conjunction with 93350 to capture the cardiovascular stress portion of the study.

As per the CPT book 93350 does not include 93320 and 93325!!!

I hope this clarifies!
 
As I said in my response, without the report I could not code correctly, however, IF the physcian did the stress echo with ecg monitering AND was present AND supervising AND interpreted it AND it was done in the office the correct code is 99351. If the doppler and color flow were also done then the add on are correct. Since the only information given was that these codes were denied it is really impossible to tell how this should be coded. By the way, there is no 26 modifier shown on coders_rock's response to me, so it was either not used or this was not done in the hospital
 
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I am having the same problem regarding 93351, 93325 and 93320. I am requesting the complete medical records this will allow me to make an accurate assessment. What I am gathering I think it should be 93351, 93352 and 93325.


Help Please advise and thanks a bunch
 
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93325 can i bill it more than once

if the pt is a multi pregnancy can it be billed more than once with mods . BCBS denied stating only covers once ??
 
you would not bill 93352. the hospital bills for that, unless you made a typo.

also, if the nurse that supervised the stress echo is owned by the hospital and not a member of your staff, then you cannot bill for the supervision(93016). which means you can't bill with 93351-26, either.

if everyone is on your staff, i would bill:

93351-26
93320-26
93325-26

If only your provider is on your staff, then i would bill:

93350-26
93320-26
93325-26
93018

hope this helps

Jeremy L. CPC
Shawnee Mission Cardiology Associates
 
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