Remote device check while Inpatient for another illness

4777clee

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I have a claim that was not paid by Medicare for a patients routinely scheduled remote 90 day device check (93297 and 93299). The patient was inpatient at one of our facilities at the same time (for another reason), by our Cardiologist billed a visit for that date too. A/R is stating that we cannot bill for the remote check since the patient was in the hospital. I don't recall coming across this issue before.......any input/clarification/resources from my fellow Cardio coders would be appreciated.
 

thomas7331

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The biller is partially correct. Any technical services rendered while a patient is in a facility are considered a component of the case rate payment to the hospital, but professional services can be billed and paid separately. So 93297 can be billed an paid under part B since that is a professional service code - use POS code 21 to indicate that the patient was inpatient on the date of service. 93299, being a technical service, is the responsibility of the facility to bill as part of their inpatient claim. If your practice provided this to the patient during their stay, you would need to invoice the hospital and get payment from the hospital directly. If this is an isolated instance, it may not really be worth the trouble.
 

rachaebo

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Remote check while in INPT status for another reason

So you are saying that the provider is not to bill for the Remote check while the pt is in the hospital for another reason and that the provider should initiate payment from the hospital?
Thank you
 

thomas7331

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So you are saying that the provider is not to bill for the Remote check while the pt is in the hospital for another reason and that the provider should initiate payment from the hospital?
Thank you
For the technical component, yes. Medicare and most other payers will deny any technical component billed by an independent provider if the patient was inpatient in a hospital on that entire date of service. All technical components are inclusive to a hospital's payment while the patient is there.
 
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