Haissam Posted Fri 28th of February, 2014 10:31:26 AM
Please help me bill the following 93880, 76770 and 93975. we want to bill Technical components only. Please help with what cpt is first second and last.
SuperCoder Answered Mon 03rd of March, 2014 06:58:20 AM
Although Correct Coding Initiative (CCI) edits don't bundle the code combinations you mention, that doesn't mean payers will consider performing the services together medically necessary.
Case in point: Highmark, Pennsylvania's Medicare contractor, published local coverage determination (LCD) L27504, "Non-Invasive Cerebrovascular Arterial Studies." The LCD states that "it is usually unnecessary to perform more than one type of physiological study on the same anatomic area." If the radiologist must perform a second test because the first isn't interpretable, the LCD instructs you to report only the successful test.
Watch for: You may report the codes together if the case meets the payer's medical necessity requirements, however. For example, "physiologic studies and a duplex scan performed on the same day will be considered medically necessary if there is a 50 percent stenosis demonstrated on the duplex scan, or there are significant symptoms present," the LCD states.