We are getting denial for code J7040 in the facility setting when billing with code G0121 and J2250 for procedure considered to be inclusive to the procedure code. Should we not be getting separate payment for J7040 as we are billing it with G0121 which is 100% covered per the PPACA guidelines for preventive screening.
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Tag Archives: Should
How Should FFR-CT be billed?
I have seen in another post where someone asked about billing for FFR-CT and the response was to use cpt 93571. The problem with this FFR code is that it is using a Doppler transducer. The FFR-CT is more of a 3D image reconstructed from a base CT or CCTA (Coronary CTA).
Reference from 2014 Imaging Technology News.
"The Heart Flow FFR-CT software is housed at HeartFlow Inc.s headquarters in Redwood City, Calif. A
healthcare professional electronically sends the patients CT scan data to HeartFlow where a case
analyst creates 3-D computer models of different sections of the patients heart and runs a blood flow
simulator program on the models. After analyzing the data and the models, the case analyst
electronically sends a report with the estimated FFR-CT values displayed as color images of the
patients heart."
Should FF-CT be coded as an add-on 3D Reconstruction? Does anyone know how this is properly coded? Thanks.
Reference from 2014 Imaging Technology News.
"The Heart Flow FFR-CT software is housed at HeartFlow Inc.s headquarters in Redwood City, Calif. A
healthcare professional electronically sends the patients CT scan data to HeartFlow where a case
analyst creates 3-D computer models of different sections of the patients heart and runs a blood flow
simulator program on the models. After analyzing the data and the models, the case analyst
electronically sends a report with the estimated FFR-CT values displayed as color images of the
patients heart."
Should FF-CT be coded as an add-on 3D Reconstruction? Does anyone know how this is properly coded? Thanks.
Why You Should Worry About PAMA and Tests
Do you think you don’t have to worry about PAMA because you are a physician clinic? You may be wrong and this assumption could cost you big bucks. Background Section 216 of the “Protecting Access to Medicare Act of 2014” (PAMA) requires the Centers for Medicare and Medicaid Services (CMS) to change how it pays […]
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