Resolved Heart monitoring device billing

[MichelleK_1162]

Hello,
If a heart equipment lets say 93923 was used in the ER but is not owned by the hospital should there be a modifier?

If the patient is admitted after being in the ER can the equipment still be billed since it’s not owned by the hospital.

Thanks,
Michelle

 

[Lori]

Technical Component (TC) is assigned when the physician does not own the equipment or facilities or employs the technician.

CPT Modifier Decision Grid Tool

Free Job Aid: This CPT Modifier Decision Grid Tool will help you pick the correct CPT Modifiers at your medical coding job.

www.cco.us

When to Apply Modifiers 26 and TC

Understanding the appropriate use of modifiers 26 and TC is key to filing clean claims and avoiding denials for duplicate billing.

www.aapc.com

 

[MichelleK_1162]

Thank you.

For my 2nd paragraph, I would like to know if it’s billable.

If the patient is admitted after being in the ER can the equipment still be billed since it’s not owned by the hospital.

Thanks,
Michelle

 

[Lori]

It is a valid code to bill but only your payer decides what they will or won't pay.

https://www.coopersurgical.com/wp-content/uploads/ABI_2020_Reimbursement_Guide.pdf

 

[MichelleK_1162]

Ok thank you so much