# cpt 93306 & 93308 plus mcaid question



## thejewel (Jun 11, 2013)

Greetings,

Have anyone had a problem with a carrier changing cpt 93306 to 93308 if it was billed within a 6month period.  The carrier stated that only 1 for every 6month if same dx is being used.  And if another was billed they will change it to 93308 and use it as a f/u.    

I have not done mcaid billing in a while so I have a question.  If  mcaid was billed and they denied the claim for out of network can we bill the pt?  Mcaid was not check to see if pt was eligible for that month.


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## Twixle2002 (Jun 12, 2013)

We haven't had a carrier change the code, but we have had denials.  You then have to appeal and show why the need for another test within the 6  months..IE:  recurrent/ worsening chest pain.. abnormal ekg(changes from previous ekg)


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## Jess1125 (Jun 12, 2013)

thejewel said:


> Greetings,
> 
> Have anyone had a problem with a carrier changing cpt 93306 to 93308 if it was billed within a 6month period.  The carrier stated that only 1 for every 6month if same dx is being used.  And if another was billed they will change it to 93308 and use it as a f/u.
> 
> I have not done mcaid billing in a while so I have a question.  If  mcaid was billed and they denied the claim for out of network can we bill the pt?  Mcaid was not check to see if pt was eligible for that month.



I do have a certain commercial insurance payor who won't change the 93306 but will give us payment instead for what they pay us for 93308. I've heard that if a complete echo was done in the last 6 months we can't bill for a complete again (according to insurance)Personally, I haven't seen this in writing ever in the 12 years I've been doing cardiology coding that there's a frequency limitation on a complete echo. I usually transfer the acct to commercial insurance staff to question this. 

Jessica CPC, CCC


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## thejewel (Jun 12, 2013)

Greetngs, thank for your input.  It truly help me a lot.


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## shruthi (Sep 18, 2013)

If 2 Echos are done on same day, then can we bill 2nd Echo with 76 modifier?

Need you suggestions.

Thanks.


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