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Need modifier dor DPA codes

Lina Posted Mon 07th of April, 2014 13:42:48 PM

When billing DPA test (Pulse Wave Analysis devices)
We submit CPT: 93922
95921
95922
Do we need to append modifier to any of them?
Just got a denial for 95921 and 95922, but got paid for 93922

SuperCoder Answered Tue 08th of April, 2014 10:04:56 AM

The requirement is that at least two of the tests should be performed in order for code 95921, Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including two or more of the following: heart rate response to deep breathing with recorded R–R interval, Valsalva ratio, and 30:15 ratio, to be reported. If only one test is performed, modifier '52' should be appended to indicate that a reduced service was provided.

(Do not report 95922 in conjunction with 95921)

Lina Posted Fri 18th of April, 2014 10:39:36 AM

So I guess it will look this then:

93922
95921 52

thank you again

SuperCoder Answered Mon 21st of April, 2014 07:10:11 AM

Exactly.

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