# Echo Interp & Hosp Visit on Same Day



## bmcquilling (May 4, 2010)

Can anyone tell me what is appropriate way to bill a hospital visit (99232) and an echo interpretation only (93306-26) that were done on the same day by the same physician?  The hospital visit (99232) has not been paid, and I am being told the hospital visit is an integral part of the echo interpretation, therefore, no reimbursement is being made for the hospital visit.


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## Cyndi113 (May 4, 2010)

Did you add a -25 modifier to your 99232?


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## theresa.dix@tennova.com (May 5, 2010)

You would need to add modifier 25 to the 99232.


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## jessica1974 (May 11, 2010)

You cannot bill for a sub hosp visit & an echo on the same day.  It will be denied by the carrier. You either have to bill for one or the other. I have found this out by trial and error. Every time we bill both the hosp visit gets denied.  I def wouldn't use a mod 25 because if you tag one on to every time they do that you could come up for audit as over usage on that modifer. Hope this helps


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## littlebitt00 (May 18, 2010)

A modifier 25 should be appended on the E/M service to indicate separate.  I hope this is helpful to you.


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## jlb102780 (May 18, 2010)

I add mod 25 on mine and they pay just fine


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## GBielskis (May 19, 2010)

*Subseq day/echo same day*

We bill that combination all the time and get paid for both without a 25 modifier.  The echo is a diagnostic procedure with no global.  You might want to look if the subsequent day is within global of another procedure.  If it is for a different diagnosis or reason, then a 24 modifier would be attached to the subsequent day.


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## davecripps (Mar 29, 2011)

This is recent (6 months or so) problem for our practice & like device checks with an E&M visit only with commercial insurances.  I believe it to be appropriate to add a 25 because the E&M services are done separately from the interp.  But I wondering what changed and when and where to find documentation of this because it seems kind of outrageous from a provider standpoint?  I'm going to search the payers websites but does anyway has any additional information I can use to at least support us adding the 25 modifier initially to the E&M visit rather than once the claim is denied?  Thank you


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## Jess1125 (Apr 1, 2011)

GBielskis said:


> We bill that combination all the time and get paid for both without a 25 modifier.  The echo is a diagnostic procedure with no global.  You might want to look if the subsequent day is within global of another procedure.  If it is for a different diagnosis or reason, then a 24 modifier would be attached to the subsequent day.



I agree. We bill both without a -25 all the time and get paid for both. I agree, echo's don't have a global period so you shouldn't have to put a -25 on.  Global concept doesn't apply.

Jessica CPC, CCC


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