Wiki Stress Echo's

[jewlz0879]

Is there a compliance officer or a medical auditor that can back me up here (or prove me wrong)? Or anyone that has documentation on this? My delimma below:

Dr. A wants to bill (separate entity):
93351
93320-TC
93325-TC

They have asked our physician to do the professional component

Physician B (my doc)
93350-26
93320-26
93325-26
93018

Am I wrong in thinking that we would be denied? My concern is since physician A already billed the global code (93351), we will be denied when we try to bill 93350-26 and 93018 since those codes were already billed and reimbursed to physician A.

Also, per NCCI 93350/93351 cannot be billed together.

Thanks for any reponses!

 

[Jess1125]

Is there a compliance officer or a medical auditor that can back me up here (or prove me wrong)? Or anyone that has documentation on this? My delimma below:

Dr. A wants to bill (separate entity):
93351
93320-TC
93325-TC

They have asked our physician to do the professional component

Physician B (my doc)
93350-26
93320-26
93325-26
93018

Am I wrong in thinking that we would be denied? My concern is since physician A already billed the global code (93351), we will be denied when we try to bill 93350-26 and 93018 since those codes were already billed and reimbursed to physician A.

Also, per NCCI 93350/93351 cannot be billed together.

Thanks for any reponses!

Julie, I like your code choices for your doctor and would say your codes are correct. Dr. A I would say has to modify how he bills his portion of the stress echo. I would think he would use 93350 as well because he/she can't use 93351 because he's not doing all the components of the stress test obviously if you're billing the 93018. He should maybe be billing 93350.TC instead?

Jessica CPC, CCC

 

[jewlz0879]

Nobody understands, or believes me! I'm so frustrated. Is it because they are CMC's? I don't mean that any disrepect but it's not AHIMA or AAPC. I'm the only CPC where I work. All the other girls are CMC's.

I've told them they need to bill the TC but this is their response, "well we had another group doing it and they never got denials, or told us we were doing it wrong. We are billing what our doctor is doing"

I can't seem to make them understand.

Thanks, Jess.

Wish I could find something in writing! Hopefully it will come to light, eventually. Oh well.

 

[heatheralayna]

The 3M coding reference states the following "In this range of codes, transducers are placed on a patient's chest to record a two-dimensional echocardiograph, which uses ultrasound to visualize the heart's function, blood flow, valves, and chambers. Code 93350 applies to the echocardiography completed while the patient is at rest and exercising on a treadmill or stationary bicycle with or without medication and includes M-mode recording, when performed. Code 93351 also includes the performance of continuous electrocardiographic monitoring with supervision by the physician.

93351 = physician supervision, Dr A can't bill that if he isn't there

93350 - TC is the route I would go

HTH

Heather Shaw, CPC, CIRCC