Wiki Cardiology Codes

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Alexisjo

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Hi,
I working in a billing department they asked me a coding question, I am a new coder and not familar with cardiology coding. Medicare rejected a claim that had the following codes:

93303-26 - Complete Echo
93320-26 - Doppler - Complete
93325-26 - Color flow

The medicare rep indicated that 93325 is included in 93320 so should it be billed: 93303 -26 and 93320 -26. Or should they use the new code 93306-26 and 93320-26
 
93303 is for congenital anomalies...is that what the patient has? If so, I think you coded it right and perhaps the Medicare rep is confused with 93303 vs 93306. 93320 and 93325 both state to report with 93303. Otherwise, 93306 would be the only code if not a congenital anomaly.
 
EvaCPC

Before the 2009 cpt updates we used to bill 93350 93015 in the office, however a new code has been added 93351. I am aware that the 93351 replace 93350 and 93015. What if my doctor does not own the machine what cpt would I use?
 
Need alittle more information to properly answer your question. We recently discussed how to split bill the stress echo. If your dr does not own the equipement how were you billing 2008 stress echocardiograms? Who bills for the technical portion?

Dolores
 
In 2008 My Dr was using his own maching without color. So this is how we would bill our echos
93307
93320
93015
93350
In 2009 my Dr borrows a machine from the hospital with color doppler so thats were my question comes in. We are borrowing the machine DR is performing a stress test and a stress echo. What CPT do I use?
 
A 93306 will be billed for the Echo, it sounds as though he is doing them in his office, and is he actually leasing the equipment? If so DO NOT put a 26 on it, should be billed globally.

The only time you put a 26 on the Echo is if it is done in another facility, for the technical part of it. If there is a tech in your office along with the doctor doing it then it would be billed globally.

I hope this helps
 
Thanks rhodak, I was confusing the mod 26 and mod TC. However, I have another question. In the hospital is it possible to bill
93306-26-59
93350-26
93320-26-59
93325-26-59
93016
93018
If not please explain why. CCI allows it.
 
For hospital stress echocardiograms you bill with the following codes: 93016, 93018, 93350-26 93320-26 93325-26. You can only bill for the professional fee, the hospital will bill for the technical portion. You do not need to add modifier 59 unless the stress echocardiogram is bundled with another cardiac procedure.

You cannot bill 93306 with this because 93350 description states "during rest and cardiovascular stress test using treadmill, bicycle excercise and/or pharmcologically induced stress, with interpretaton and report". You are actually "double dipping" if you bill 93306-26 & 93350-26 together and one of the codes will be denied.

Hope this answers your question
 
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