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Echo Interp & Hosp Visit on Same Day

  1. Default Echo Interp & Hosp Visit on Same Day
    Medical Coding Books
    Can anyone tell me what is appropriate way to bill a hospital visit (99232) and an echo interpretation only (93306-26) that were done on the same day by the same physician? The hospital visit (99232) has not been paid, and I am being told the hospital visit is an integral part of the echo interpretation, therefore, no reimbursement is being made for the hospital visit.

  2. #2
    Location
    Phoenix, AZ
    Posts
    620
    Default
    Did you add a -25 modifier to your 99232?
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  3. Default
    You would need to add modifier 25 to the 99232.

  4. #4
    Location
    Charleston, WV
    Posts
    97
    Default
    You cannot bill for a sub hosp visit & an echo on the same day. It will be denied by the carrier. You either have to bill for one or the other. I have found this out by trial and error. Every time we bill both the hosp visit gets denied. I def wouldn't use a mod 25 because if you tag one on to every time they do that you could come up for audit as over usage on that modifer. Hope this helps
    Jessica Chandler CPC, COC, CPC-P, CPB, CCC
    Charleston, WV

  5. Default
    A modifier 25 should be appended on the E/M service to indicate separate. I hope this is helpful to you.

  6. #6
    Location
    Jacksonville Florida
    Posts
    126
    Default
    I add mod 25 on mine and they pay just fine
    Jammie Barsamian, CPC, CCC, CEMC, CCS-P, CPMA

  7. #7
    Location
    Bay City Michigan
    Posts
    24
    Default Subseq day/echo same day
    We bill that combination all the time and get paid for both without a 25 modifier. The echo is a diagnostic procedure with no global. You might want to look if the subsequent day is within global of another procedure. If it is for a different diagnosis or reason, then a 24 modifier would be attached to the subsequent day.

  8. Default
    This is recent (6 months or so) problem for our practice & like device checks with an E&M visit only with commercial insurances. I believe it to be appropriate to add a 25 because the E&M services are done separately from the interp. But I wondering what changed and when and where to find documentation of this because it seems kind of outrageous from a provider standpoint? I'm going to search the payers websites but does anyway has any additional information I can use to at least support us adding the 25 modifier initially to the E&M visit rather than once the claim is denied? Thank you

  9. #9
    Default
    Quote Originally Posted by GBielskis View Post
    We bill that combination all the time and get paid for both without a 25 modifier. The echo is a diagnostic procedure with no global. You might want to look if the subsequent day is within global of another procedure. If it is for a different diagnosis or reason, then a 24 modifier would be attached to the subsequent day.
    I agree. We bill both without a -25 all the time and get paid for both. I agree, echo's don't have a global period so you shouldn't have to put a -25 on. Global concept doesn't apply.

    Jessica CPC, CCC

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