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ABI Doppler with Carotid or Echo or Stress/Nuclears on same day

Guna Posted Wed 20th of August, 2014 06:10:43 AM

We are now doing ABI Dopplers in our office is there any reason insurance wise that we cannot do them on the same day as another ultrasound test, ie Carotid or Echos? or even on the same day as our Stress/Nuclears?

SuperCoder Answered Mon 25th of August, 2014 11:55:25 AM

In our research, we have not come across any such information. Can you please share example of any denials that you may have received while using any such combination of codes?

There are some edits developed by CMS for some specific ultrasound and doppler code combinations where ultrasound examination for same region or structure is considered as inclusive to doppler or duplex examination. However, you may override such edits by appending modifier 59, Distinct procedural, service with the ultrasound code provided that medical records have a valid reason for performing both exams and medical necessity supports the requirement of both exams.

Thanks!!

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