Denial for 93306 same day as and inclusive to 78452

alwyzjazzephae

Contributor
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We have been receiving denials for Echo's (93306) performed same day as Nuclear Stress's (78452) due to the fact that they are included in the Nuclear study. Does anyone know of any documentation that shows these procedures can be separately billed same day and not inclusive to one another?

We have the same issue with the stress portion of the Nuclear (93015) being denied for the same reason, yet there is a paragraph in CPT that clearly states they can and should be billed separately. Looking for some similar documentation to back up billing the Echo same day. Thanks for any help!
 

jenneverett

Networker
Local Chapter Officer
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54
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Bangor, ME
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Is it a particular payer? Do you have a different diagnosis for the echo and nuclear study?

We do get paid for an echo and nuclear on the same day with different diagnosis... Have you tried a -59 on the echocardiogram?

We also bill the 93015 on the nuclear stress and get paid without problems.

If it is a particular payer, they may have a problem in their own system after an upgrade.

We've recently had odd rejections/denials because of this. Medicare included:(

I hope this helps.

Jennifer
 
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