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Plain Stress and Stress Echo Same Day Coding

Chris Posted Wed 03rd of June, 2020 16:53:51 PM
What is proper coding when CPT 93015 and 93351 are performed on the same day? It seems reasonable that if a plain stress(93015) and is abnormal and a stress echo is ordered (93351) that they could be done on the same day. I have attempted to use 59 modifier and sent along both reports showing that separate services were rendered, but 59 modifier was not accepted.
SuperCoder Answered Thu 04th of June, 2020 06:37:48 AM

Hi Chris,

 

Thanks for your question.

 

There is CCI edit between these two codes and modifier is not allowed. This is the reason you received a denial for the code with modifier 59. These codes cannot be reported together on the same day in any circumstances.

 

Also please see CPT manual instruction below the code 93351 saying “Notes: Do not report 93351 in conjunction with 93015-93018, 93350. Do not report 93351-26 in conjunction with 93016, 93018, 93350-26

 

But if you still think that these should be paid and want to submit the claim again, please talk to payer’s representative first before sending the claim to them and discuss the situation and ask them if they may pay both these codes on the same day telling them you have the reason.

 

Please feel free to write if you have any question.

 

Thanks.

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