Wiki 93280

[heart123]

im having a hard time getting paid from aetna with dx Z95.0 any help please

 

[crystaljos]

This is only a status code, need to use the patient's condition for conducting lead pacemaker. Could use the same code that was used for the initial visit with z95.0 as secondary.

 

[pedscardio1]

are you using a modifier 26 with 93280?

 

[heart123]

yes im using a 26 mod

 

[pedscardio1]

so even if the provider himself/herself is doing the programming, adjustments, analysis and review you would still pend a 26 modifier?

 

[CodingKing]

so even if the provider himself/herself is doing the programming, adjustments, analysis and review you would still pend a 26 modifier?

You would only report 26 if another entity will be reporting the TC modifier. If your office owns the equipment then your office would be billing the global charge.

 

[pedscardio1]

Thank you for your response, we do not own the device, its a Medtronic device. For this particular visit, the doctor did not need the rep here for the T/C part, she was able to do the programming and analysis herself. Would the 93280 still be appropriate?