# More questions re: Bubble Study...



## Lisa Schwaesdall

Is everyone billing 96374 (previously 90774) for bubble study performed with echocardiography?
McKesson Clear Claim shows the 96374 will deny as incidental to the echo.  Has anyone been able to justify the addition of modifier 59 to this code due to this edit?


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## kmorrow

Under the CCI edits, the injection or infusion (e.g., 90774 or now 96374) is included as a component of the stress test.  Separate charges should not be submitted for that service.  Are you billing a stress test as a component of the echocardiography? That may the snag.


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## Lisa Schwaesdall

Having to use 2008 codes in McKesson, I submitted the coding scenerio: 93303 & 90774 & received the edit stating "90774 was disallowed as global to procedure 93303".


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## pgraettinger

Quick question concerning coding of a Echo Bubble Study

Can we code the results of the test as the Indication/reason (diagnosis code) for performing the test (93303)?

Currently we are charging 93306, because the Physicians list the indications for the test as Stroke/TIA. According to the LCD, these will not cover 93303 as being Medical Necessity. Our director is stating that we can code the result of the test as the reason for performing the test. I do not agree.


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## carroll5

*echocardiogram, complete*

Please excuse any mistake I may make, I have never used this forum before, I hope to do it right...

We have a question about billing echocardiograms for 2009.  We know there is a code 93306 which is new.  It appears this includes the 93320 and 93325 and yet Medicare has advised me to bill the 93306, 93320-59, 93325-59.  The commercial carriers are paying 93307, 93320 and 93325, which according to the CPT book is not correct either.  Any help anyone can give would be greatly appreciated.  Thanks...


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## Heartcoder 

*in response to new echo code*

The 93306 now encompasses the 93320 and 93325. Effective Jan 2009 the 93307 can no longer be billed with 93320 and 93325. Payers should not be accepting claims with these 3 procedures in 2009 unless they are for older dates of service. 

In Mass, Medicare is reimbursing us for the 93306 claims. 

The 93303 (congenital echo) can be billed with 93320 and 93325 as long as your diagnosis supports a confirmed congenital issue. 

I would call a supervisor at Medicare to get some guidance if you are not getting paid for your 93306 echos this year.

Hope this helps.


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## beatjones

*Transthoracic echo for congenital cardiac anomalies*

I have a question to the 93303 code. CCI edit now bundles the 93320 to the 93325. I haven't found any guidance on how these are billed. Should -59 be attached to the 93325 when billing with the 93320. Does this now mean there has to be a distinct service?

Thank you


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## deeva456

For billing a bubble study there isn't a separate code for the injection of the agitated saline. You would just bill the echo as 93306 or 93307 or if a limited bubble study is done, 93308.


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