Cardiology Coding Alert

Question: Our practice recently billed for an echocardiogram using codes 93307, 93320 and 93325. We also performed a carotid duplex scan on the same day and coded it 93880. The color flow doppler was denied, which doesnt seem appropriate. How can we get reimbursed properly in this situation?

Missouri Subscriber

Answer: The carotid duplex scans CPT code (93880) includes doppler color flow on the carotid artery, so the color flow claimed for the echo are automatically bundled, says Stacey Elliott, CPC, business office manager with COR Healthcare Medical Associates, an 11-physician cardiology practice in Torrance, Calif. Medicare and many other carriers automatically may deny payment for the color flow doppler in these circumstances. Therefore, cardiologists should add modifier -59 (distinct procedural service) to the 93325 (doppler echocardiography color flow velocity mapping [list separately in addition to codes for echocardiography]) to indicate that it was performed on a separate site or at a different time.