Nicole Posted Wed 26th of June, 2013 19:48:51 PM
We are a CAH hospital also have a rural health clinic. The providers are employees of our facility. We perform 48 hr holter monitors in the hospital. Our department hooks up the machine and gets the printout. Our providers will do an interpretation for the holter monitor. So we know we must bill out the global component of 93224. We are not sure if this is to go out on a UB or a 1500 claim? Can you offer some advise on how to properly bill out this charge. Also similar situation with the stress test. We use the cpt code 93015
SuperCoder Answered Fri 28th of June, 2013 02:31:01 AM
I have directed this query to my editor. She is working on it ans will respond soon.
SuperCoder Answered Fri 28th of June, 2013 13:32:23 PM
Since facility is doing both technical and professional parts, you can use UB-04 to bill 93224. Following is list of x-walked Rev. codes:
Cardiology - Other Cardiology
For stress test also, it's the same since facility is doing everything. You need to use CMS-1500 when the physician comes from outside, and use mod. TC / mod. 26 based on what the physician does. In this case, when the instrument is provided by facility, use UB-04 to bill for the instrument supply (HCPCS code).
Professional Fees - General Classification
Professional Fees - Radiology - Diagnostic
Professional Fees - EKG