# FYI on the echo billing ~ new changes, again



## jlb102780 (Jul 14, 2009)

Hi everyone. I just found out some news today that I thought I would pass along, incase you haven't heard.  Here's a copy of the article on ACC's website:

*Coding Alert: NCCI Corrects Echo "Add on" Codes

On April 1, 2009, the National Correct Coding Inititive (NCCI) removed its restriction on billing the echocardiography "add-on" codes (CPT 93320 and 93325) together. The NCCI accepted the ACC recommendation to retroactively remove the coding edit and permit medical providers to bill these codes with the appropriate echocardiography CPT code during the same visit on the same day.

+ 93320 - Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to code for echocardiographic imaging); complete
+ 93325 - Doppler echocardiography color flow velocity mapping (List separately in addition to code for echocardiographic imaging) 

The College advises its members and office practices to resubmit any claims on or after Jan. 1, 2009 denied for using both CPT 93320 and 93350 together. For more information about coding changes for 2009, see The ACC 2009 Guide to Cardiology Coding and Payment Changes.*


Hope this helps some of your practices get paid higher for this service 

Jammie Mack, CPC


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## deeva456 (Jul 14, 2009)

The article is in regards to billing the add-on codes 93320 & 93325 together it does not say to bill 93320 & 93325 with 93306. Until recently, when billing 93320 & 93325 you would add modifier 59 to 93325, now you do not have to. The appropriate echo codes the edit refers to is 93303 93304 93312 93314 93315 93317 93350 93351

Why would you bill 93320 & 93325 with 93306 as this code includes the spectral display and doppler color flow?  At least this is how I read it...any other opinions? 

Dolores, CPC, CCC


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## jlb102780 (Jul 15, 2009)

Hey Dolores 

Your reply makes total sense. I spoke with my billing manager this morning regarding this, she stated that they spoke with someone at Medicare and was told to bill it this way. They are not taking the 93307 for some reason or another. To me, it does not make sense to bill the 93306 with the 20 and 25 either. I'll keep my eye open on these claims to see if they pay. Its just weird that someone at Medicare would have said to bill them this way. My manager may have been told wrong, wouldn't be the first


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## jlb102780 (Jul 15, 2009)

Well, I just got off the phone with Medicare. This has been bothering me all morning trying to get this clarified. The lady I spoke with at Flordia Medicare did confirm that they are accepting the 93306 with the 93320 and the 93325. I'll keep everyone informed on if these actually get paid. I don't feel that this is correct since it states on the 93306 that the spectral and color flow are included. The lady at Medicare did say that they are not taking the 93307, which is crazy since its still an active code. Just thought I'd share the info I found out. Sorry if I started any confusion


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## jerseygirl66 (Jul 20, 2009)

I think the correction to CCI is in regards to billing the 93320 and 93325 together but not referring to 93306.  Medicare had been denying the 93320 when it was billed with 93325 for a stress echo.  It is appropriate to bill these add on codes seperately if they are used during stress echo but not appropriate to  bill seperately if billed with 93306.  If you check the CCI edits, 93320 and 93325 are included in 93306.  It is payable with a 59 modifier, IF INDEED THE SERVICE WARRANTS A MODIFIER-- which is an unusual occurence so don't go adding 59 just to get paid.


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