Wiki Holter Monitors Outsourcing the Scanning and Analysis

Staceyw

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We are a cardiology practice that outsources the scanning and analysis of Holter monitors. Our providers connect the monitors, disconnect the monitors and do an interpretation in the office. We are billing a separate claim using 93226 indicating outside lab in box 20 of the HCFA 1500 to indicate the technical component of the scanning and analysis by an outside provider. We are using place of service 81. Our claims are being denied for inappropriate place of service. Any suggestion or has anyone else had this problem?
 
Billing guide for Profee (HCFA-1500) and Facility (UB-04)

Good day..!

Please find the logic here if we want to bill in (Health Care Financing Administration) HCFA-1500/ CMS- 1500 claim form we can bill only Professional component in 1st place for the record if we are Billing with Technical component which is TC it is going to be Denied/Rejected.If we want to Bill for the Technical component we need to bill in (Uniform Billing) UB-04/CMS-1450 form only.

I think this will Useful.

Thanks,
Suresh Myneni CPC..!
 
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