Wiki Billing tee with tavr

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Marybeth

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Elizabethton , TN
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I am trying to bill a 93318 during a TAVR and a 93312 following the procedure as follows:

93318/26
93312/26/59/76

Medicare Replacement has paid for this however I cannot get the claim out the door for Medicare - scrubber states that the procedures cannot be billed together.

Any assistance would be helpful
 
Can you post your TAVR report, please? I understand your question but think these both should be bundled. Just want to doublecheck with an op report, thanks.
 
93318 - during monitoring of intraoperative course, wire and catheter was vusualized passing the aortic valve. Balloon valvuloplasty was followed by repeat imaging. After the balloon valvuloplasty, there is no evidence for any aortic root contusion or disection. Aortic regurgitation is mild post balloon valvuloplasty.

93312 - Post Valve Deployment TEE evaluation: This reveals the valve is seated at the appropriate level. Leaflet mobillity is normal. There is trivial aortic valve regurgitation or central nature. three is no significant mirtral regurgitation. There is a linear structure below the aortic valve which could represent the old aortic valve or an intimal layer of that valve that is moving in the left ventricular outflow tract. There is another linear structure from the noncoronary cusp which appears to be a small intimal flap, however, structures from the aortic valve supravalvular attachments cannot be excluded. Pericardial effusion size is similar at about 0.4 cm. There is no evidence of cardiac tamponade. Distal end of this fibrilar structure appears to be in the ascending aorta. LVH and sigmoid-shaped septum is similar to prior implantation. Left maini coronary artery was evaluated in multiple views.

--------This is the 2nd TEE series that I have billed. The first series was a 93312 with a 93318 and a 93312. A medicare replacement plan had no problem paying for those procedures together.
 
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