Wiki Billing a 93923 for upper and lower etemities

[xmtzappa@aol.com]

We bill for 93923 on upper and lower extremities, during an office visit. What modifier/s should we be using?

 

[pscanlan]

The answer really depends on the circumstances.

1) Was there an E/M performed alongside? If so, add a 25 to the E/M code.
2) Do you own the equipment used for the imaging? If not, add a 26 to the 93923. If you do own it, then you bill for the whole service (not TC or 26 but global) and no modifier is needed.

Further modifiers would depend on further circumstances. It's hard to know which apply without knowing more about your typical claim.

 

[Davieda Skobel]

Billing a 93923 for upper and lower extremities

I agree that if you are also doing an E/M you need to add a 25 modifier and the question regarding the ownership of the equipment would also require either a 26 or TC modifier but aside from that according to AMA CPT Professional "when both the upper and lower extremities are evaluated in the same setting 93923 may be reported twice by adding modifier 59 to the second procedure."

I hope this helps. I find a lot of my answers in my CPT book. I know that the electronic coding programs are very popular but you just can't beat the good old books!

Good Luck,
Davieda Skobel CLPN, CPC
Ohio