Cardiology Coding Alert

Question: We are opening a vein clinic in our practice. We own the equipment, but another group would like to lease the equipment from us. How should we bill this out to patients? Should we bill the technical component or interpretation, or can we bill both?

Michigan Subscriber

Answer: You should contact your health care attorney to ensure that the arrangement does not violate any STARK or anti-kickback laws. And you should remember that how you bill for equipment use depends on whether the other party is using the equipment and interpreting the studies.

If the other group is leasing the equipment and interpreting the studies, it would bill for the complete service. For instance, if the equipment you are leasing is Doppler echocardiography equipment and the other group is using the equipment to provide services, it would apply the echocardiography codes (93303-93304, 93308, 93312, 93314-93315, 93317 or 93350) and the Doppler codes (93320-93325). Also, it would need to let Medicare know that the services it is providing are purchased services. Private payers likely would cover the services under global periods.

If physicians in your practice interpret the services for the group leasing the equipment, you would bill the professional component by appending modifier -26 to the appropriate CPT codes (e.g., the Doppler codes above), and the group leasing the equipment would bill for the technical component by appending modifier -TC to the appropriate CPT codes.