Wiki 93283,93000,99214 billed together???

[coders_rock!]

My Dr. reported 99214, 93000, and 93283. The insurance company only paid 93283. Does anyone know the guidelines for reporting an EKG with an in-person programming device with an E/M -same dr., same date, same dx?

 

[jewlz0879]

To bill the 93000 and 93283 you would need a distinct separate reason for the EKG as it can't be related or for the same condition as billed with 93283. If 93283 was planned, I would strongly consider not billing for the E&M. I would, however, bill the E&M if 93283 was unplanned or unrelated to the reason for the OV. Maybe the patient came in experiencing some edema or SOB unrelated to the device, then I would bill for the OV.

When you look at NCCI it shows 93000 with a "1" meaning a modifier is allowed and needed for reimbursement when billed with 93283 under the correct circumstances.

HTH

 

[LouiseR1]

I agree but remember to plac the 25 modifier on the office visit, and the 59 modifier on the ekg. To use these modifiers, they have to be seperately identifiable and distinct from the procedure they are being bundled to.