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Thread: Is this proper coding

  1. #1

    Wink Is this proper coding

    AAPC: Back to School
    I visited an office recently and was observing the coding procedures. I am unsure of one procedure. What do you think?

    93000 is for an ekg. Global charge. It is done in the office with the offices equipment, with the office employee.
    For some reason Medicare is dening it. ( I did not review the EOB)
    They are billing it this way
    93010-26 professional component
    93005-tc technical component
    Medicare is paying this way. Instead of finding out why the global is not being paid they are billing the 2 seperate components.

    Should this be billed this way? Is there a rule stating this is unbundling or unethical?

    Last edited by calexander; 09-01-2007 at 02:27 PM.

  2. #2


    Are they Rural Health?

  3. #3
    Join Date
    Apr 2007
    Kansas City, MO

    Default Is this proper coding

    We had a group of physicians a few years ago start having all of there EKG's and x-rays denied by Medicare. We didn't realize that their zip code fell into the PSA's (Physician Scarcity Area) and once we knew that we had to start splitting out any service that had a professional and technical component. So my guess would be that this provider is in a PSA or an HPSA.
    Angela Jordan, CPC
    AAPC of Kansas City
    National Advisory Board Representative Region 5

    Medical Revenue $olutions
    Senior Managing Consultant


  4. #4
    Join Date
    Apr 2007
    Bay City


    If they are in a PSA then this would be the correct way to bill for there EKG's otherwise they should bill just the 93000.

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