Wiki HPSA and 93016,93017,93018

SLBK53

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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?
 
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?

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
 
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!
 
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