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.

Facebook
Twitter
LinkedIn
Email
Print

CPT® copyright 2021 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.