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mwells2020

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When billing 93010 and 31500 together what modifier do I need to get them both paid? Thank You!
 
That's somewhat of a broad question. Have you checked the CCI edits? If there is no relationship between the codes, you need to check for a payer policy that may be bundling the services & follow the guidance they provide.
 
trarut said:
That's somewhat of a broad question. Have you checked the CCI edits? If there is no relationship between the codes, you need to check for a payer policy that may be bundling the services & follow the guidance they provide.
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There is an edit between these codes, which I don't understand.
 
mwells2020 said:
When billing 93010 and 31500 together what modifier do I need to get them both paid? Thank You!
Click to expand...
Per the NCCI manual, "Many procedures require cardiopulmonary monitoring, either by the physician performing the procedure or an anesthesia practitioner. Since these services are integral to the procedure, they are not separately reportable. Examples of these services include cardiac monitoring, pulse oximetry, and ventilation management (e.g., 93000-93010, 93040-93042, 94760, 94761, 94770)."

So if the interpretation of the EKG for which you're billing was an integral part of the procedure, it shouldn't be billed. If it was a separately identifiable service not related to the other procedure, then you can bill it with a modifier 59 (or XU, for example, if your payer accepts these) to show that it was unrelated.
 
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