Stress echo in hospital setting

10marty

Networker
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At our local hospital we are contracted for the supervision and interpretation of stress echo's. We are not hospital employee's. We are billing 93350-26, 93016 and 93018. The hospital is billing 93351 for the exam. We have some concerns about this. Everything i have read leads me to believe that 93351 would be used in the office setting, or possibly if we were employed by the hospital and they paid us. In our situation what should the hospital be billing?Any thoughts?
 

kbarron

True Blue
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Ossipee, NH
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If the hospital is billing for their portion, I would belive that it would be for the equipment only. Any other responses?
 

camilleb

Guru
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Arlington TX
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It is my understanding that it would be the other way around for the hospital. 93351 was established to report a stress echocardiogram combined with a complete stress test. The 2009 CPT changes Insider's view uses this code as an example in the office only. 93350 does not include the stress test.
If you check your fee shedules, you will also see that this code (93351) does not breakdown by tech or prof components. All of my sources for clarification indicate that this service is reported for the Office only. Talk with a coding manager at the hospital for your concerns. I hope this helps.
 

10marty

Networker
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That's the problem, the hospital consultants have told the coders to use 93351 until Medicare clarifies the code. To complicate matters there is now a TC and -26 modifier for 93351. From what I have read these would be used if an internist who owns the equipment supervised the exam and the cardiologist interpreted the exam, but in the office setting.

I welcome any other thoughts on the subject.

MJ
 
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