Wiki coding cpt 4 code 93352 in hospital

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bmkardok

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Hi everyone,
I am having trouble with procedure code 93352. When the service is provided in the hospital it is being denied. When procedure code 93352 is billed in the office we are receiving payment. Does anyone know if there is updated documentation regarding the echocardiogram contrast administration(93352) when performed with an echocardiogram
(93351/26)in a hospital setting? I have looked everywhere I really would appreciate any help or opinion anyone has?
Thanks,
Brenda
 
93352: Use of echocardiographic contrast agent during stress echocardiography (List separately in addition to code for primary procedure)

Medicare Fee Schedule shows PC/TC indicator as 0 for 93352.
"Physician service codes. This indicator identifies codes that describe physician services. Examples include visits, consultations, and surgical procedures. The concept of PC/TC does not apply since physician services cannot be split into professional and technical components. Modifiers 26 & TC cannot be used with these codes."

And I don't find any CCI edits against 93351 and 93352. So your physician should be able to code 93352 when done in the hospital.

So what reason is Medicare giving for the denial?
 
Medicare denied because of the place of service. Medicare is stating that the facility provides the contrast so the provider can not bill out 93352. I believe that procedure code 93352 is for the administration of the contrast. I am wondering since the facility provides the contrast does someone with the facility administer the contrast. Maybe someone that works for a facility will know. Thanks
 
The correct code for steress echo performed in a hopital setting would be
93350,26
93320,26
93325,26
93018
That's how we bill it and no problem with Medicare

Dawn CPC,CCC
 
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