Billing > Billing

ECHO'S IN OFFICE

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HeidiK:
Hello again!

I wanted to add one more thought...  Be sure to confirm with the doctor how you are applying the modifiers, especially if you are not required to perform coding for this client.  They should be submitting the information correctly coded and ready to go for you.

The payment for the Echos done in the hospital setting billed with -26 will be paid at a lesser amount than in the office.  This is one of the main reasons for being able to split the billing between reading/interp only vs. technical component.  The hospital will receive the portion of payment related to the equipment.  Any Echos done in the office will be paid at the full allowed amount.

Radiology billing is similar to this topic as well.

Heidi Kollmorgen, CCS-P

TerriTye:
Example of one of my problems:

I have a fee ticket and the only thing marked is:
93307GS - ECHO 2D MODE
93320GS - DOPPLER ECHO
93325GS - COLOR FLOW

Now.....do I need an office cpt as well? Ex: 99214/25 or do I only bill the echo codes. It lists the GS with the CPT - do I use that or leave it off? (this is done in office)
Again, have never done cardio billing and learning as I go, so any info is greatly appreciated.

Thanks in advance!

Merry:
Was anything else done for this patient that would necessitate billing an E/M code other than the procedures performed?  Are you questioning whether you should go back to the provider and ask about the office visit or ste you asking if you should add it?

Merry:
Confused about using the GS modifier.
I am not a coder but was curious so looked it up.

GS modifier
Description:
Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level

Guidelines/Instructions:
This modifier may be submitted with the following HCPCS codes:
J0881 through J0882
J0885 through J0886
Q4081

HeidiK:
Some offices will perform an Echo when the patient comes in with symptoms necessitating the test.  In those cases, yes an E/M should be billed.  At other times, the doctor will have the patient schedule a time to come back for the test only and typically doesn't see the patient at that future visit - no E/M would then be billed.  They could bill a 99211 for the technicians time but that is entirely up to the physician to decide and add to the billing form.

I'm not sure why the -GS modifier is listed?  Modifier -GS is described as "Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level" and is used with HCPCS codes J0881-J0882, J0885-J0886 and Q4081. 

There may be something missing here?

Heidi Kollmorgen, CCS-P

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