Frank ,
 See my response to Brian. I will keep the issue alive until Bill Sarraille
tells me it's dead. Sorry I received your e-mail after I responded to Brian.
Robert T Kane
Phoenix Cardiovascular
Doylestown PA
----- Original Message -----
From: "Franklin W. West" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, February 05, 2001 6:11 PM
Subject: 93325


> Bob,
>
> I'm uncertain regarding your point. You are correct in noting the current
> definition of 93325 is specific to echocardiography and you are correct in
> noting that CPT is in no way limited by the specialty of the provider (in
> fact, you may have been present at the meeting where a HCFA representative
> noted that any psychiatrist would be paid for the performance of cardiac
> transplant under the program - medical licensure being unlimited and a
> states rights issue). I don't believe that I suggested anything that
would
> violate either of these facts.
>
> However, given the current definition of 93325 is specific to
> echocardiography, the use of this code in other than cardiac evaluations
> would appear to be inappropriate in my opinion. I understand that this
was
> historically not the case, but it has been since 1/1/99. Personally, my
> admittedly low risk-tolerance level would not allow my use of this code to
> describe what I do when performing non-cardiac duplex scanning and I would
> find it analogous to billing for 93307 and/or 93320 (also echocardiography
> CPT codes) on non-cardiac cases. That is, I would not care to be in a
> position of having to defend to an Assistant US Attorney the use of
cardiac
> ultrasound CPT codes when not used to evaluate the heart. Somehow, the
"but
> they've got a code" argument seems more than a little weak, and not
material
> to the point. But then, that may not have been your point ...
>
> *************************************************
> Franklin W. West
> [log in to unmask]
> *************************************************
>
> -----Original Message-----
> Sent: Saturday, February 03, 2001 10:54 AM
> Subject: Re: venous insufficiency
>
> Frank,
> As you have mentioned in your communication CCI does not bundle color flow
> and our vascular duplex scans anymore. The new CPT code definition is
> Doppler echocardiography color flow velocity mapping (List separately in
> addition to codes for echocardiography). Some would get the impression
that
> you could not bill this code with a duplex vascular study. However, if you
> read the Instructions for Use of CPT paragraph 2 " It is important to
> recognize that the listing of a service or procedure and its code number
in
> a specific section of this book does not restrict its use to a specific
> specialty group. Any procedure or service in any section of this book may
be
> used to designate the services rendered by any qualified physician."
> Robert T Kane
> Phoenix Cardiovascular
> Doylestown PA
> ----- Original Message -----
> Sent: Friday, February 02, 2001 9:08 AM
> Subject: Re: venous insufficiency
>
> > Dwight,
> >
> > With the advent of HOPPS, the Correct Coding Initiative now applies to
> > Intermediaries (has for some time impacted the Part B side). On the
down
> > side, it bundles a large number of procedures. On the up side, it did
> away
> > with local edits. Given CCI does not bundle 93325 (color) with either
> 93320
> > (Doppler) or 93327 (B-mode), under the Medicare Program, you do get paid
> for
> > color when performing an echocardiography. A previous CCI edit did
bundle
> > 93325 with duplex scan codes, but this was removed a number of years ago
> and
> > the AMA CPT Editorial Panel revised the definition of 93325 to be
specific
> > to echocardiography, thus making it unnecessary to bundle with the
duplex
> > scan codes. If a Medicare Intermediary is denying claims based on a
local
> > edit, I would suggest you (1) appeal and (2) notify you local HCFA
> Regional
> > Office.
> >
> > *************************************************
> > Franklin W. West
> > [log in to unmask]
> > *************************************************
> >
> > -----Original Message-----
> > From: [log in to unmask]
> [mailto:[log in to unmask]]On
> > Behalf Of Michael, Dwight
> >
> > Bonnie,
> > Don't rush to judgement on the echocardiography folks. While
> > reimbursement is better for echo, those of us who run combined
> echo/vascular
> > labs see similar problems with both modalities. Many intermediaries
will
> > deny payment for Color Flow Doppler on an echocardiogram if the patient
> also
> > had a vascular duplex exam on the same day. Since color flow is bundled
> > into the vascular charge, they say that you are billing for the same
> > modality twice on the same patient, even though it is two totally
> unrelated
> > uses of color flow. Additionally, if a patient has an echocardiogram
> > performed, the physician then determines that the patient needs a stress
> > echo, you can only bill for one or the other and not both. Since resting
> > wall motion images must be obtained for the stress echo, it is assumed
> > (inaccurately) that this constitutes a complete resting echocardiogram.
> > However, you are quite correct regarding the inequity of reimbursement
> > between the two disciplines (echo & vascular). Vascular studies are
more
> > "tedious" and therefore take longer to perform. Some would argue that
> > vascular requires a higher level of "skill" to obtain quality images. I
> do
> > both. Therefore I choose to NOT get into that discussion. The two
> > modalities are just different. Both require a high level of knowledge
and
> > skill and the learning curve continues on forever, (if you want to be
> good).
> >
> > Dwight Michael, RDCS, RVT
> > Dirctor, Non-Invasive Cardiovascular Services
> > Birmingham Baptist Medical Center-Montclair
> > -----Original Message-----
> >
> > Ahhhhhh! We all feel your pain. Sorry pal but it's the same pay for the
> same
> > CPT code. To make matters worse the CPT code is the same for the upper
> > extremity as it is for the lower so can't bill for both those either.
Bet
> > echocardiology does not have this gross inequity in their unbundled
> > codes!!!!!!!!! (don't get me started) More for our governmental
relations
> > people at SVT, SVS, ISCVS, SDMS etc etc etc to be working on. bj
> >
> > Bonnie L. Johnson RDMS, RVT, FSVT
> <snip>