Belinda Frisch
Guru
I am in need of some opinions/information on 93926 (duplex scan of LE; unilateral OR limited).
The following is an excerpt from an SIU from our Medicare carrier NGS:
"The following services are by definition limited or unilateral studies and should also be billed only with a number of services of one (1): 93882, 93888, 93890, 93892, 93893, 93926, 93931, 93971, 93976, and 93979.
A bilateral modifier (50) is not appropriate with these codes. Bilateral or complete studies should be reported with the appropriate codes, but with only one (1) unit of service. The appropriate anatomic modifier should be
appended to the unilateral procedure codes."
According to this, as I interpret it, bilateral studies should not be coded using 93926.
We recently had a patient with multiple vascular studies on the same day and 93926 was marked (along with 93923 and 93880). When I tried to ascertain LT or RT (consistent with the anatomic modifier requirement above), I was told it was a bilateral study that was "limited" (included: external iliac, common, proximal, and superficial femorals w/ PVR)which started the discussion.
First question is: does anyone have documentation of what is a "complete" bilateral study (93925)?
Second: what is your interpretation of the above and/or practice for coding this scenario? Specifically, do you think 93926 should be used to bill a "limited" BILATERAL study?
Thanks all for taking the time to answer.