Author Topic: 93923?  (Read 1209 times)

shanbull

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93923?
« on: November 08, 2013, 11:20:15 AM »
This is a brand new procedure for us, is anyone familiar with it? I'm getting denials for "invalid diagnosis code" when it's paired with 401.9 (continued arterial hypertension) and it looks like some insurers flat out do not cover it, while others require specific documentation or criteria to be met so it's not bundled with E&M. We are paying an outside company $50 a patient for this procedure so we definitely need to figure out how to get paid for it. Any info would be appreciated.

RichardP

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Re: 93923?
« Reply #1 on: November 08, 2013, 01:18:32 PM »
Does anything at the following link help you?  Note the paragraph at the top of the page, and this sentence at the bottom of the list of codes:

Modifiers TC and 26 should be used as appropriate to indicate that the technical or professional component was performed.

http://www.biomedix.com/userfiles/file/CPT-test%20descriptions%2012-10.pdf

shanbull

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Re: 93923?
« Reply #2 on: November 08, 2013, 03:56:47 PM »
Does anything at the following link help you?  Note the paragraph at the top of the page, and this sentence at the bottom of the list of codes:

Modifiers TC and 26 should be used as appropriate to indicate that the technical or professional component was performed.

http://www.biomedix.com/userfiles/file/CPT-test%20descriptions%2012-10.pdf

Yes thank you! This is really helpful. I also found out that the list of acceptable diagnoses for this code is quite restricted as well.