Cardiology Question for the Week of October 1, 2018

Question:

In a hospital or outpatient setting who should be billing for Definity when administered for a stress echo with contrast if the office does not own the equipment? Here are the options we’ve come up with:

• Physician bills CPT^® code 93352
• Hospital bills HCPCS code C8930
• Both bill Q9957 for the contrast

Answer:

If you are asking about billing for the contrast media itself (Q9957), only the facility providing the technical component may bill for the contrast material. The physician may not bill for the contrast material even if he or she provides it for a procedure performed at the hospital because it is part of the technical component. The physician may contract with the hospital to provide the contrast, and the hospital may pay him for it, however.

If you are asking about billing for the administration, code 93352, which you list in your question, is not billable under outpatient prospective payment system (OPPS) and should only be billed by the physician. The physician should also report one of the following stress echo codes, as appropriate:

CPT^® is a registered trademark of the American Medical Association.

This question was answered in an edition of our Radiology Compliance Manager. For more hot topics relating to cardiology and radiology services, please view our store, or call us at 1.800.252.1578 ext. 2.