Cardiology Question for the Week of December 23, 2019

Question:

Do you have any guidance for codes 93303 and 93304?

Answer:

Do not use codes 93303 and 93304 when congenital heart disease is suspected but not found; codes 93306–93308 may be reported instead. (Source: CPT Assistant, May 2015, Volume 25, Issue 5, page 10)

• For hospital-based services, on the CMS-1500 claim form, assign modifier 26 to describe the professional component. For Medicare patients, hospitals will not need to assign the TC modifier, as billing on the UB-04 claim form implies billing for the “technical component.”
• If performed in a physician-owned, non-facility setting in which the physician owns the equipment, employs the staff, and performs and reads the study, no modifier is required as this constitutes global billing.

This question was answered in our Peripheral & Cardiology Coder. For more hot topics relating to cardiology services, please visit our store or call us at 1.800.252.1578, ext. 2.