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Cardiology Coding Alert

Reader Questions:

Remember Mod 26 for TEE Claims

Published on Sat Nov 28, 2009

Question: Medicare has been denying claims that include 93312, +93320-26, and +93325-26. Should I be reporting TEEs differently? Nebraska Subscriber Answer: First, be sure that you append modifier 26 (Professional component) to 93312 (Echocardiography, transesophageal, real time with image documentation [2D] [with or without M-mode recording]; including probe placement, image acquisition, interpretation and report) when the cardiologist performs a hospital transesophageal echocardiography (TEE). Modifiers: Your question indicates that you already are appending modifier 26 to +93320 (Doppler echocardiography, pulsed wave and/or continuous wave with spectral display [List separately in addition to codes for echocardiographic imaging]; complete) and +93325 (Doppler echocardiography color flow velocity mapping [List separately in addition to codes for echocardiography]). Code 93312 has professional and technical components just as +93320 and +93325 do, so you need to indicate that you are reporting only the professional component of each code, if that is the case. Place of service: Second, [...]
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