Cardiology Coding Alert

Question: Do I have to append modifier 25 to 93660 for an E/M on the same date as a tilt table test?

Nevada Subscriber

Answer: You should append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) to the code for an E/M service performed on the same date as 93660 (Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention).

Caution: Code 93660 has a global period indicator of 000 on the Medicare Physician Fee Schedule. That 000 indicator means: “Endoscopic or minor procedure with related preoperative and postoperative relative values on the day of the procedure only included in the fee schedule payment amount; evaluation and management services on the day of the procedure generally not payable.”

Consequently, before you report an E/M with modifier 25 on the same date as the tilt table test, you should be sure to confirm that documentation shows the E/M is separately identifiable from the work usually required for 93660.