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
 

fwnewbie

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New Haven, IN
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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.
 

fwnewbie

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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.
 
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