Wiki Venous Studies - Upper/Lower

[Patricia L Diaz]

My cardiologist read two Venous Studies in the hospital, one was for the upper extremities the other for the lower extremities. Both test were bilateral and done at the same time. CPT does not have upper/lower for this test procedure code 93970, so how would I bill?

93970/26
93970/26/51

I would really appreciate any advice...

 

[sbicknell]

Code 93970-26 for the upper bilateral and code 93970-26-59 for the lower bilateral. Here is a paste from MCare website

The CPT code 93970 is described as a “complete bilateral study”. The CPT code 93971 states: “unilateral or limited study”. Both codes can be used for bilateral studies; 93970 for complete, and 93971 for limited.

If a complete or limited bilateral study is done on both the upper and the lower extremities, the corresponding code can be reported once for each study performed (i.e., once for the upper extremities and once for the lower extremities).

Providers should append modifier 59, distinct procedural service, to the second code to indicate that two separate, distinct studies were performed. There should be a separate written report / interpretation for each study performed.

 

[Patricia L Diaz]

sbicknell....Thank you so much for you help!