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Thread: ICD program/fu E&M

  1. #1
    Join Date
    Apr 2007
    Richardson, TX

    Default ICD program/fu E&M

    AAPC: Back to School

    I'm not as familiar with device cks, programming ect and need some help, please.

    2/8/11 we billed
    99214, 25 427.31, 425.4
    93283, 26 427.31, 425.4
    They only paid for the OV.

    05/03/11 we billed
    99214 (no 25) 401.9
    93823, 26 401.9
    They only paid for the 93283

    I didn't see a limit on billing the 93283 code for example: once every 90 days/30 days. I did notice however, the 99214 and 93283 were billed with the same dx codes. A -59 doesn't seem like it would be the answer either since we billed with 25. Should we ensure that the ov is strictly for another problem and only bill the 93283?

    Pt has Medicare.

    Any input is appreciated! Thanks
    Last edited by jewlz0879; 10-27-2011 at 02:03 PM.
    Julie Graham, BA, CPC, CCC

  2. #2
    Join Date
    Apr 2007
    Grand Canyon Coders



    I find that Medicare (Palmetto) pays for E/M without 25 modifier when I use only the appropriate V code V45.01 for the device check.

    Thanks, Priscilla


  3. #3


    if its an ICD check the v code to bill it with would be v45.02. Its its a pc check then it will be v45.01..

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