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Cardiac Catheterization, Transthoracic Echocardiograms, Doppler Echocardiography Claims Reprocessing
Information posted September 4, 2009: Effective for dates of service on or after July 1, 2009, some benefit changes were made to procedure codes for cardiac catheterization, transthoracic echocardiograms, and doppler echocardiography. Click on the title to view the details.

Effective September 24, 2009 for dates of service on or after July 1, 2009, some of the benefit changes will be reversed. Affected claims will be reprocessed, and payments will be adjusted accordingly. No further action on the part of the provider is necessary.

Cardiac Catheterization

Procedure codes 93501, 93505, 93508, 95310, 93511, 93514, 93524, 93526, 93527, 93528, 93529, 93530, and 93531 may be reimbursed as follows:

Type of Service

Changes

Surgery

May be reimbursed to physicians and radiological and physiological laboratories in the office setting.

May be reimbursed to ambulatory surgical centers.

Technical component

May be reimbursed to radiological and physiological laboratories in the office setting.

Professional interpretation component

May be reimbursed to physicians in the office, inpatient hospital, or outpatient hospital setting.

Transthoracic Echocardiogram and Doppler Echocardiography

Procedure codes 93303, 93304, 93307, 93308, 93320, 93321, and 93325 may be reimbursed as follows:

Type of Service

Changes

Radiology service total component

May be reimbursed to physicians and radiological and physiological laboratories in the office setting.

May be reimbursed to outpatient hospitals.

Professional interpretation component

May be reimbursed to physicians in the office, inpatient hospital, or outpatient hospital setting.

Technical component

May be reimbursed to radiological and physiological laboratories in the office setting.

 

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