Question:
Answer:
You may report an E/M service and 93970 (Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study) on the same claim. Whether you need to append modifier 25 (Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service) may depend on your payer.Explanation:
The global period for 93970 is XXX, according to the Medicare Physician Fee Schedule. Medicare's Correct Coding Initiative (CCI) manual, chapter 1, section D, states that if you have a truly separate E/M, you may report it on the same day as a XXX procedure. The manual goes on to say that you should append modifier 25 to the E/M code. (As mentioned above, different payers may have different requirements for use of modifier 25, particularly because you won't find E/M codes bundled with 93970 in the listed CCI edit pairs.)Take care:
The CCI manual sets out the following rules:Resource:
The CCI manual is available online at www.cms.gov/NationalCorrectCodInitEd/.Bonus tip:
If both bilateral upper and lower studies are performed on the same date and/or session, code 93970 twice and append modifier 59 (Distinct procedural service) to one of the codes.