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In: Nursing

National Correct Coding Initiative (CCI Edits)         INSTRUCTIONS: Review the following code pairs. Determine if you can...

National Correct Coding Initiative (CCI Edits)        

INSTRUCTIONS: Review the following code pairs. Determine if you can bill together, assuming documentation supports it. If yes, which code is the second listed code? Make certain you add a modifier -59 to this code.

Show exactly how you would bill the code(s).

Code Pairs                                          Billable together (Y/N)                      How billed     

94010 and 94060

93000 and 92953

30100 and 30200

30801 and 30130

44950 and 50020

50040 and 51702

59400 and 59414

10080 and 10081

12031 and 12032

20610 and 26340

Solutions

Expert Solution

CPT code 93000 denotes a routine electrocardiogram (ECG) with at least 12 leads, including the tracing, interpretation, and report.

CPT 92953, Under Other Therapeutic Cardiovascular Services and Procedures.Here lets take the example of Temporary transcutaneous pacing (Procedure 92953);

Temporary cardiac pacing is used to maintain a normal heart rate in people whose own heart rate is not pumping enough blood around the body. This may be in slow heart rhythms, fast rhythms or when the heart fails to beat.

So since the temporary cadiac pacing is done after the routine electrogram . We know that , Modifier 59 is used appropriately for a diagnostic procedure which precedes a therapeutic procedure only when the diagnostic procedure is the basis for performing the therapeutic procedure. When a diagnostic procedure precedes a surgical procedure or non-surgical therapeutic procedure and is the basis on which the decision to perform the surgical procedure is made, that diagnostic test may be considered.

So yes they can be billed together with 59 modifier


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