Wiki Billing for EECP

[creinhardt]

I have a cardio. telling me the proper Non-Medicare billing for EECP is a three code combination of CPT 92971, 93922, and 99211. I can't find any support for this in CPT Assist. but can anyone point me to any Cardio. assoc. guidelines on billing for EECP?

 

[Torilinne]

Looking at various LCDs from different states/insurances, it looks as though most will let you code it with either 92971 or G0166. The only covered diagnosis is for stable angina, 413.0 - 413.9. You would report this per treatment session.

Not knowing where you're located, I would certainly reference the LCD for the patient's insurance. I only found one insurance that listed the additional code 93922 or 93923 which could be reported along with the EECP code. That's not to say you can't report it with other insurances but I would check. As for also reporting the 99211, I probably wouldn't as it is most likely inclusive to the procedure(s) being done.

Be ready to submit medical notes for the patient if asked by insurance as they are very restrictive on covered conditions and they require the physician to show the patient has co-morbidities, etc that won't allow for surgical intervention.

Hope this all helps! Good luck!

Torilinne
SCC, CPC, CGIC