We are having a discussion among our coders. Our location is eligible for HPSA and HPSA credits are only paid on physician services, not on technical portions. Our question is: Under Medicare guidelines, is it correct to unbundle 93015 stress test which is done at our office and bill its components, 93016-AQ, 93017, and 93018-AQ, in order to get the HPSA credit?
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Wiki HPSA and 93016,93017,93018
- Thread starter SLBK53
- Start date
I work for a big practice and one of our locations is in a HPSA designated area. When there are stress tests done at this site and the patient has Medicare they are billed out with the components billed out separately, 93016/93017/93018. I don't have issues.
Jessica CPC, CCC
vidraj
Guru
Hello all,
Found this discussion thread as currently we are facing the same denials on 93015 , Medicare claims.
The Stress tests (both ETT and Nuclear) are being done at our (HPSA enrolled) Cardiologist's office location.
Would like to confirm if
- We bill all 3 codes (93016, 93017,93018) separately? and
- Do we need any specific modifier ?
( As I see AQ- physician providing a service in an unlisted Health Professional Shortage Area (HPSA) above .Is this needed?)
Can anyone share their experience in billing this scenario for 2022?
TIA as always!
Found this discussion thread as currently we are facing the same denials on 93015 , Medicare claims.
The Stress tests (both ETT and Nuclear) are being done at our (HPSA enrolled) Cardiologist's office location.
Would like to confirm if
- We bill all 3 codes (93016, 93017,93018) separately? and
- Do we need any specific modifier ?
( As I see AQ- physician providing a service in an unlisted Health Professional Shortage Area (HPSA) above .Is this needed?)
Can anyone share their experience in billing this scenario for 2022?
TIA as always!