Wiki NCCI bundling edit with 93296 & 93294

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drgold

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Has anyone ran into a bundling edit message when coding CPT 93296 for the remote technical download of the pacemaker data and CPT 93294 for the remote professional portion of the test. I keep getting a bundling edit and a modifer is not allowed. The company representative is telling the MDs that both codes should be allowed. Thanks
 
Under Encoder Pro there is no CCI edits for the 2 codes, I have yet to start billing them but my doc and I are going to bill them together, cause you have the employee which is the tech downloading everything and the doc reviewing everything. There is no longer one code that you can put a TC on and PC.
 
93296 & 93294

I have notes in my CPT from teleconferences (x 2) that 93296 can be reported with 93294 or 93295. It shouldn't be a problem. The only edit I have listed would be for time frame (only once per 90 days).
 
We are just now seeing denials for 93296- My understanding is to keep billing 93296 and 93295 together and medicare will go back and pay all of them?
 
codes 93297 & 93296

We are just now seeing 93294 & 93297 combinations rejecting the 93297. The NCCI indicates a 1 so we are going to try a 59.

These codes were not in the Heart Rhythm Society memo, which also says to hold the claims until after 04/01 or rebill denied claims after 04/01, they are not going to reprocess them automatically.
 
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