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Sometimes the providers say "93306" in the Procedure performed, but they don’t mention color flow in the report, they don’t have Doppler measurements, or both.
Sorry if this is dumb, I am new to this!
I work for a practice in Spokane, a couple times a month a few of our providers will interpret echo’s for Newport which means we send some of our MA’s up to Newport with our equipment to see those patients. There are a few of those patients that have a status if Inpatient which means that they are in the hospital (Inpatient Newport Hospital would be the POS). As of now we are coding these visits with two separate tickets. One ticket has a modifier 26 for the interpretation and a second ticket with a TC modifier.
I am confused on why we have two tickets being billed to the same place. No one in the practice i work for can seem to answer that question.
Does anyone kind of have a similar situation?
However, if patient has indications that makes the echocardiogram medically necessary, e.g. shortness of breath, murmur, CHF, etc.. doesn’t it make a stronger case to code the indications rather than the "mild" results?
We usually code both the indications and results but technically which one would make it "more" correct in the eyes of Medicare and other insurances?
Thanks!
Has anyone had experience with this and if so is payment carrier specific?
Thank you in advance for your guidance.
Thank you
I need help!
I am semi-new to OB billing.
My question is in reference to Fetal echos and Doppler studies together.
76825
76827
93325
The doctor wants to also bill 76821 & 76820 with the above codes.
He is stating its always done together.
This is an example of one interpretation:
"The patient presents for a fetal echocardiogram due to IVF using partients own frozen egg (31 years old) and cervial length
evaluation. OB history significant for one full term vaginal delivery.
Transabdominal sonography reveals a viable fetus in breech presentation. Maximum Vertical Pocket of amniotic fluid appreciated
measures 3.2 cm with good fetal movement observed.
Fetal Doppler studies are within normal limits.
A detailed examination of the fetal cardiac structures was performed using 2D, M-Mode, color Doppler and spectral Doppler
Echocardiographic techniques.
The fetal situs was normal. The examination revealed a normal appearing 4 chamber view and a normal left axis deviation.
Cardiac size and location were within the normal limits. Cardiac chambers were within the normal limits. Both the interventricular
and interatrial septa were visualized and appeared to be without any defects.
The aortic and pulmonary outflow tracts were visualized and noted to be arising out of the left and right ventricles respectively. The
cross-over relation of the outflow tracts was clearly visualized. The inferior vena cava, superior vena cava and pulmonary veins
were seen and appeared within the normal limits.
M-Mode echo examination revealed a normal sinus rhythm. The fetal heart rate was regular throughout the exam period."
Does that one line justify 76821 & 76820.
I have been searching and searching and can not find anything on these 5 codes together. As far as CCI edits it seems to be fine but i just need to know if they should even be billed.
Thank you to anyone who can shed some light on this!
Irene Canela, CPC, CPB
I have a urologist who is billing out for 76873, echo, transrectal, prostate volume study for brachytherapy treatment planning, separate procedure. However, there are no orders or plan to treat these patient’s with brachytherapy. Can this cpt code still be used if they do indeed take prostate volume measurements?
Any help or guidance is appreciated.
Thanks
Kathleen