Wiki jalwcoder


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Billed TEE procedure 93312, 93320 & 93325 with 99233-25. TEE procedure codes being denied because incidental to 99233-25. Any suggestions?
Per NCCI they are bundled and no modifier is applicable. Your physician will have to decide what y'all bill; do you want to bill for the TEE or Subq 99233?

I'm confused as to what's bundled? Per NCCI, I don't see that a subsequent visit is bundled with any of those codes? If the visit was done and a decision was made to do the echo based on necessity, the 25 modifier is appropriate. Medical necessity must be shown for the echo. Perhaps the visit was even for treatment of a separately identifiable condition requiring a distinct diagnosis code?

Perhaps more info on the visit would be helpful.....

There is no reason why you can't bill a TEE on the same day as a subsequent visit. I'd appeal the denial.

Per CPT E/M guidelines,

"The actual performance and/or interpretation of diagnostic tests/studies ordered during a patient encounter are NOT included in the levels of E/M services. Physician performance of diagnostic tests/studies for which specific CPT codes are available may be reported SEPARATELY, IN ADDITION to the appropriate E/M code. The physician's interpretation of the results of diagnostic tests/studies (ie, professional component) with preparation of a separate distinctly identifiable signed written report may also be reported SEPARATELY, using the appropriate CPT code with modifier -26 appended."

Jessica CPC, CCC
My apologies; I was looking at NCCI for 2011 and not 2012. I have since updated. Thank you! This is what I saw from 2011 NCCI - that is why I said what I did and overlooking the "9". So sorry!

93312 99231 20001030 20001030 9
93312 99232 20001030 20001030 9
93312 99233 20001030 20001030 9