Question Is 93356 billable from a professional component?

kcolum81

Networker
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73
Location
Bradenton
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If your billing for the doctor, you bill 93356-26, if for the hospital or clinic bill 93356-TC
I don't see that TC/-26 are appropriate for this code. We are getting insurance denials because 93356 was billed along with 93303-26, 93320-26, 93325-26. The hospital is also billing for this charge. I'm trying to confirm if we (hospital and professional) should be billing this code or just the hospital since they performed the exam? I appreciate your help.
 

ellis3350

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Galloway, OH
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93356 doesn't take a 26/TC modifier. I code for profee and we bill the 93356 but the hospitals don't.​

Per question to Dr. Z last year -​

93356 for Facility Coding​

Date: Mar 2, 2020

Question:​

Is new add-on code 93356 appropriate for facility coding?

Answer​

According to the Medicare OPPS fee schedule it is reportable by hospitals. Medicare bundles the payment for code 93356 into the echocardiogram, but other payers may not. -Ruth Broek
Question ID : 13558
 

kcolum81

Networker
Messages
73
Location
Bradenton
Best answers
0

93356 doesn't take a 26/TC modifier. I code for profee and we bill the 93356 but the hospitals don't.​

Per question to Dr. Z last year -​

93356 for Facility Coding​

Date: Mar 2, 2020

Question:​

Is new add-on code 93356 appropriate for facility coding?

Answer​

According to the Medicare OPPS fee schedule it is reportable by hospitals. Medicare bundles the payment for code 93356 into the echocardiogram, but other payers may not. -Ruth Broek
Question ID : 13558
So to confirm, there should be one 93356 billed either by the hospital OR profee, correct? Is it appropriate to bill for both profee and hospital?
 
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