Wiki 93351 - We are a facility based practice

[smithan]

We are a facility based practice and we have cardiologists that do Stress Echocardiograms up in our Diagnostic Dept. We have for years been using the following codes on the physician side and the facility side for a SE:

93350, 93016, 93018

It just recently came to light that we should be using 93351 only for the physician and facility side. I am under the impression that 93351 is utilized if you own your own equipment and practice. Can anyone shed light on this? What is your resource for utilizing these codes? Thanks

 

[peeya]

93351 with modifier 26 is for the Professional component & 93351 with modifier TC is for the facility side..

Hope this helps!

 

[cargo]

When 93351 first came out, there was no 26-TC split and the instruction was to use this code for office only. Later in 2009, CMS added a 26-TC split and revised their instruction to use this code -93351/26- for physician charges of S/E in a facility setting. Not all private carriers have added the 26-TC, however.

Here's a link to the updated instruction which I believe was published in October 2009:

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6617.pdf