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How to code Doppler - I have a question

  1. Default
    Medical Coding Books
    We have been doing this and are having the 93325 denied as bundled with the 93320. Modifier 59 really does not seem appropriate since it is not a separate session or part of the anatomy. It however is a different procedure.
    Any thoughts...

  2. Default
    I too have a doubt in this combination.
    Why is that we are getting denials when we code 93312,93320 and 93325.
    We get denials mostly for 93325
    Any one to help????

  3. Wink
    Unfortunately it is denying because of the 93320. Look at what your physician is documenting and review the codes. If the documentation supports both of the two codes, I would bill for the procedure with the higher reimbursement. It is crazy that this is all of a sudden getting denied.

  4. Default limited echo
    What if you do a limited echo 93308? I am getting denied when our tech does doppler and color flow 93221 and 93225. I keep getting an error message from medicare saying primary procedure not found. Also when we do stress echo in the office 93351 and our tech does doppler and color flow 93320 93325 i am getting the same message. Any thoughts

  5. Default
    According to Dr. Z... CCI edits made a mistake bundling 93320 and 93325. This will be changed back on the next release of CCI edits. For now, they suggest putting a -59 on 93225. It has worked for us.

  6. Default NCCI error
    who is Dr. Z and can anyone cite a reference for the revision to the 93320/93325 bundle issue?

  7. Default NCCI Error
    I am looking for the same reference from CMS. Dr. Z is

  8. Default
    I asked CMS for help on this same situation. This was their reply.

    -----Original Message-----
    From: CMS Website Questions []
    Sent: Wednesday, June 24, 2009 1:15 PM
    To: CMS ProviderFeedback
    Subject: Coding Feedback

    The following question has been received:

    Contact Information
    Email Address:
    First Name: Gayla
    Last Name: Sharpe
    Reference #090624-000027
    Product Level 1: Medicare
    Product Level 2: Coding
    Product Level 3: National Correct Coding Initiatives Edit
    Date Created: 06/24/2009 01:14 PM
    Last Updated: 06/24/2009 01:14 PM

    Discussion Thread
    Customer - 06/24/2009 01:14 PM
    If we are only performing part of the services in CPT 93306 (TTE with color flow) and not using spectral display, how can we bill for it if 93320 & 93325 bundle into 93307 with no modifier allowed? Would it be appropriate to use 93306-52?

    -----Original Message-----
    From: CMS ProviderFeedback
    Sent: Wednesday, June 24, 2009 3:37 PM
    To: CMS CMMInquiry
    Cc: CMS ProviderFeedback
    Subject: FW: Coding Feedback

    Thank you for your e-mail inquiry regarding coding for services using CPT 93306 and possible modifiers.

    After consulting with our coding analysts, it was decided that the services you described should be coded as CPT 93306-52 (modifier).

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