Wiki cardioversion 92960 denied for component column cci edit

bhargavi

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i am a facility cath lab coder . i have cardioversion cpt 92960 denied from healthoptions( medicaid plan) stating its hitting cci edit component 2 coding. they couldn't tell me which cpt exactly was hitting component coding but i am guessing since it was billed with cpt 93005 so i applied xu modifier . my appeal was denied as well said no further action required after appeal rejection. i wanted to know if this happens again what am i suppose to be doing? any ideas? anyone having same issue?
thanks in advance
 
I don't think the EKG can be billed as it's an integral part of a cardioversion procedure. Check the notes in the cpt that come before the cardioversion section to confirm what can and can't be billed together.
 
When coding and billing procedures, it's very important the coder understand what is going on during the procedure. A cardioversion is using medication or current to convert a pathological, electrical rhythm within the heart. It makes sense that the heart has to be monitored before, during and after this kind of treatment and would be considered a part of the whole process.
Be sure you understand what is going on to avoid billing denials.
 
If your EKG was done separately from the Cardioversion...at a different time for example. You can append an XE modifier and add the time in Box 19. If your EKG was during your Cardioversion request a take back from insurance for the EKG and let them know it was billed in error. Rebill the Cardioversion after the take back.
 
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