I work in a hospital setting and every Arterial Duplex (93924) that comes in we do an ABI (93923) with the Duplex. The facility is telling me that we are unable to bill these together but there are no CCI edits with this. Can someone with vascular experience tell me if we can in fact bill these two codes together or should we only be billing the Arterial (93924). I truly appreciate the help and time with this as we have been going around in circles and I would really like to know how other facilities are doing it. Thank you so much.
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Wiki Arterial Duplex and ABI
- Thread starter leiannaglad@yahoo.com
- Start date
lgardner
Guest
I do see CCI edits with these 2 codes.
BUT, if you look in the CPT book, under 93924, it states "do no report 93924 in conjunction with 93922, 93923".
BUT, if you look in the CPT book, under 93924, it states "do no report 93924 in conjunction with 93922, 93923".
Sorry! I should not have used that code. That is for the stress test which we do not do here. If I do a 93925 and 93922 can those be billed together. I did not see any edits with that and did not see anything in the book that includes or excludes it. I tried looking up the Medicare guidelines but it looks like they should not be reported together? It states they are generally not done together but we do them on every patient.
AmandaBriggs
Expert
Does your order set include the second test or do your physicians order both tests? I'm looking at this from more of a compliance standpoint wherein you shouldn't be performing testing that isn't ordered by the treating physician. What is the medical necessity for the additional test?
Some of the orders say Arterial Duplex with ABI and some just say Arterial. The Vascular surgeons expect every arterial duplex to have an ABI done. It has been this way since I came to this facility and when I questioned them they stated our hospital stopped billing for both tests back in 2015 and when I questioned this they said we are not allowed to bill for both. Trying to speak with the providers and admin to see if we can bill for both and the correct way to do so....if this would include the physician to order each study on it's own. Any information would be greatly appreciated. Thank you.
Also I should have mentioned the arterial duplex and abi are listed together for our hospital protocol. However we are only billing for the duplex and not the abi. I have read much information in regards to billing these two codes together but the information is contradicting. I am just trying to provide my director with some concrete evidence on how it should be done. Thanks again.