Wiki pacemaker checks-we are going

[gbehrendt]

we are going to start a pacemaker clinic, and I was told that the
dr doesn't do the actual check he reviews the results, that the tech
from the company that we bought the pacemaker from comes in and does
the checks. his credentials are RN/BSN with several others.
can we bill 93288? is he considered other health care professional and bill
under the dr...the company does not charge us its part of the agreement
with buying their pacemaker.
I would really appreciate some input regarding this.
thank you in advance.

 

[rlh27]

Here is some information I found on your question. I think even though your tech is qualified, he is not staff, so you wouldn't be able to bill the TC. You can bill the PC component though.

Can a physician bill for the technical service of a remote
or in-person device evaluation if a device manufacturer
representative completes the entire service?

No. In order to bill Medicare for the technical service of a
procedure, physicians must either perform the procedure
or appropriately supervise qualified staff who complete the
procedure. In general, in-person device evaluations (CPT
codes 93279-84, 93288-90) require "direct supervision"
and remote device evaluations (CPT codes 93296, 93299)
require "general supervision" by a physician. According to
CMS claims processing guidelines, however, "supervision
requirements for physician billing is not met when the test
is administered by supplier personnel regardless of whether
the test is administered at the physician's office or at another
location". Providers should contact their local Medicare MAC
or other expert sources for additional clarification as needed.

 

[gbehrendt]

thank you very much. that is exactly what I was looking for.