Wiki E/P Studies

[ksschroeder]

I am hoping someone might be able to answer a question on how to bill correctly for E/P evals (93619 & 93620). We know that these 2 codes are for comprehensive studies. Our question is if it is more appropriate to bill these with the -52 modifier if only 2 of the 3 (HIS, RA, RV) are documented; or if we should should bill the individual codes (93600 - 93618) with the knowledge that 93621 can only be billed with 93620. We have heard arguments both ways and are having a hard time finding reputable sources for clarification.

Thank you for any help you can provide.

 

[deeva456]

Hello,
I am hoping someone might be able to answer a question on how to bill correctly for E/P evals (93619 & 93620). We know that these 2 codes are for comprehensive studies. Our question is if it is more appropriate to bill these with the -52 modifier if only 2 of the 3 (HIS, RA, RV) are documented; or if we should should bill the individual codes (93600 - 93618) with the knowledge that 93621 can only be billed with 93620. We have heard arguments both ways and are having a hard time finding reputable sources for clarification.

You would not use modifier 52 on 93619-93620. If only 2 of the 3 (HIS, RA or RV) is documented then bill the individual codes (93600-93618). The CPT provides a definition of arrhthmia induction and gives a brief explanation on how to use these codes.

Hope this has been helpful,
Dolores, CPC - CCC