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How to bill appropriate procedure code

  1. Default How to bill appropriate procedure code
    Medical Coding Books
    I'm having problem with procedure code 93320, 93325 and 93306. When the service is provided in Office setting procedure code 93306 got paid and 93320 and 93325 denied as inclusive. Can i resubmit the procedure code 93320 and 93325 with mod-26 as corrected claim?

    Can I also bill with procedure code 93320, 93325 with 93351 in Office setting? Please help.

  2. #2
    Greater Orlando
    Default You only get 93306
    First, the carrier is right. 93320 and 93325 are included in 93306. According to the Use Notes for 93320 and 93325, neither of these can be used with 93306. Comparing the description of 93306 with those of 93320 and 93325 shows clearly that the former is inclusive of the latter two CPTs.

    Persisting in billing all three of these CPTs probably constitutes unbundling.

    You can bill 93351, 93320, 93325; the Use Notes do permit that combination.

    Here, for your reference, are the CPT descriptions highlighted to show the inclusion.
    93306 — Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography.

    + 93320 — Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); complete

    (Use 93320 in conjunction with 93303, 93304, 93312, 93314, 93315, 93317, 93350, 93351) (emphasis added)

    + 93325 — Doppler echocardiograpy color flow velocity mapping (List separately in addition to codes for echocardiography)

    (Use 93325 in conjunction with 76825, 75826, 75827, 76828, 93303, 93304, 93308, 93312, 93314, 93315, 93317, 93350, 93351) (emphasis added)
    Last edited by RonMcK3; 11-25-2011 at 07:30 PM.
    Ron McKenzie, CPC-A
    Greater Orlando FL Chapter

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