37765 (90 day global)
We billed an echo during the 90 day global of cpt 37765, Medicare denied the echo saying the incorrect modifier was used. We used modifier 79? Example:1/11/07 377651/31/07 93307-79 93320-79...
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No modifier is needed because it is a diagnostic procedure, not an E&M (office visit or hospital visit) or a surgical procedure; therefore, it is not subject to the global period.Hope it helps.April
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The first time we billed the echo w/o the modifier MC denied the clm, because our coder thought too, that we did not need a modifier for the diagnostic, but MC said we needed a modifier if the charges...
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Re: 37765 (90 day global)
Okay, I'm not a cardio person (some people might say I have no heart ). Don't these echoes have technical and professional components? Are you doing both components? Or is it possible that someone...
View ArticleRe: 37765 (90 day global)
Echos can have a technical and professional component. I have had two in the last 4 months. The first was done by the hospital staff using their equipment and my cardiologist did the interpretation....
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I don't work for cardiac surgeons (I work for interventionalists) so I never ran across this problem but we have done echos on post-op patients without a problem. I believed that only E&M and...
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Ok, before I share my documentation. I do want to ask "Latty" what diagnosis was used on the echo. (it should not have been the same one as the 37765 but then I would assumer it wouldn't be since the...
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The dx for the echo was 424.0, 786.50, and 780.2; totally not related to the phlebect.
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Sorry I forgot to add the echo was done here in the office with our equipment, and the payer was Medicare. Initially, when we contacted them, they were confused on why it was denied also. I contacted...
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I just realized what the problem might be:Was the patient admitted to the hospital on the same that the echo was performed in the office?If so, this is a new problem with Medicare carriers across the...
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Just wanted to add this since I was in a hurry before. Here is the link to the MedLearn article on the CMS Bulletin:www.cms.hhs.gov/MLNMatter...MM5347.pdfApparently, Medicare had duplicate payments...
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