Wiki Billing Echo's

[apcarter]

I noticed and question regarding CPT code 93325 bundled with 93320 were receiving denials by the payers. We are currently experiencing the same issues. However, further explanation was given by one of the coders that the code 93306 was to be used in replaced of code 93325.

When reviewing the CCI edits it indicates that the modifier (9) which states that the edit has been deleted. Please explain this in detail and what is the current replacement code if any...

Thanks

 

[BINABINET]

Billing Echoes

For 2009, you only have one code for echoes (93306). This code was designed to have to prevent from filing 3 codes. 93306 includes the 3D/M-mode, Doppler and color flow components. It would be inappropriate to file 93320 and 93325 with the 93306. It is also now inappropriate to file 93307, 93320 and 93325 together. The 93320 and 93325 could still be filed with the 93312 or 93350 codes

 

[KELLERCC]

I noticed and question regarding CPT code 93325 bundled with 93320 were receiving denials by the payers. We are currently experiencing the same issues. However, further explanation was given by one of the coders that the code 93306 was to be used in replaced of code 93325.

When reviewing the CCI edits it indicates that the modifier (9) which states that the edit has been deleted. Please explain this in detail and what is the current replacement code if any...

Thanks

The diagnosis code should be your guide on coding Echos in Pediatrics. 93306 and 93307 are for non-congenital diagnoses. You should still use 93303 or 93304 with 93320 or 93321 and 93325, when coding for a congenital diagnosis.

NCCI has also removed restrictions for billing 93320 and 93325 (when billed with correct CPT codes). ACC advises to resubmit claims from Jan 1, 09 to current that were rejected using these codes together.