Cardiology Coding Alert

Reader Question:

93660 Divides Into Pro/Tech

Question: May I append modifier 26 to 93660 if the test was performed outside of our office?Colorado SubscriberAnswer: Yes. Code 93660 (Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention) splits into professional and technical components. If you're reporting only the physician's services, as in your case, you should append modifier 26 (Professional component).If you're ever unsure about which codes have professional and technical components, refer to the Medicare Physician Fee Schedule. Procedures that have professional components (modifier 26) and technical components (modifier TC, Technical component) will list separate fees for the professional component, the technical component, and the global service (professional and technical combined). Diagnosis: Many payers require 780.2 (Syncope and collapse) to support medical necessity for 93660. Under ICD-10, you would instead report R55 (Syncope and collapse).
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more