vascular studies


Orlando, FL
Best answers
I would like to know if a physician can bill codes 93923, 93925 and 93978/93979 always when he gets a referal for an Arterial Doppler and Duplex Study?
Is the physician providing a report of the study as well as performing the scan? If so what type of Physician is he? We bill these procedures out using the rendering provider as the ref provider because he is a vascular surgeon. If your physician is only doing the scan you may have to file with a TC modifier and the physician who reads the scan would file with the 26 modifier. In our case we do the scans in office therefore we don't file with a modifier because we are filing for the TC (technical component) and the 26/PC (professional component). When you file the claim without a modifier (TC or 26) you are claiming both components of the "global" package for the scan.

On the other hand when a patient is seen in the hospital and the scan is done there but sent to our physician to provide a report we file the same codes with a 26 modifier because we are not claiming the tech component as the hosp will file for that. In this case we are only claiming the professional component using the modifier 26.

Does that help?

In reference to the question I posted:

This is a Cardiologist, he states that when he receives a referral, (in or outpatient), for an Arterial, Carotid or Venous Doppler and Duplex he can include code 93978 or 93979 additional to the primary codes. Can he bill this way all the time? This doctor always performs and interp. the studies all the time so no modifier is necesary.

I will appreciate if you can help me.

Thank you.:confused:
I will ask my office manager to be sure I'm answering your question correct. I will get back to you with her response.

Have a great Christmas!!