CPT code 93660 is used for a tilt table evaluation, a test to assess how your body responds to changes in position, often for diagnosing fainting.
CPT code 93660 is used for a tilt table evaluation, a diagnostic procedure primarily used to assess the cause of unexplained fainting (syncope). During this test, a patient is securely positioned on a table that can be tilted to different angles while their heart rate, blood pressure, and symptoms are monitored. The goal is to determine how the body responds to changes in position, which can help identify issues related to blood flow and autonomic nervous system function. This code is crucial for healthcare providers to accurately document and bill for the procedure, ensuring proper reimbursement and facilitating effective patient care management.
For CPT code 93660, which pertains to a tilt table evaluation, the following modifiers may be applicable depending on the specific circumstances of the procedure and the billing requirements:
1. Modifier 26 - Professional Component: This modifier is used when the professional component of the service is being billed separately from the technical component. It indicates that the billing is for the physician's interpretation and report.
2. Modifier TC - Technical Component: This modifier is used when the technical component of the service is being billed separately from the professional component. It indicates that the billing is for the use of equipment, supplies, and technical staff.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It may be necessary if the tilt table evaluation is performed in conjunction with other procedures that are not typically reported together.
4. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by the same provider on the same day. It indicates that the repeat procedure was necessary.
5. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by a different provider on the same day. It indicates that the repeat procedure was necessary and performed by another provider.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Although less common for this specific procedure, this modifier is used when a laboratory test is repeated on the same day to obtain subsequent results. It may apply if the tilt table evaluation includes diagnostic testing that needs to be repeated.
These modifiers help ensure accurate billing and reimbursement by providing additional context about the services rendered. It's important for healthcare providers to use these modifiers appropriately to avoid claim denials or delays in payment.
CPT code 93660, which pertains to a tilt table evaluation, is reimbursed by Medicare, provided it meets the necessary criteria outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used to reimburse physicians and other healthcare providers for services rendered to Medicare beneficiaries.
However, reimbursement is contingent upon several factors, including medical necessity and adherence to local coverage determinations (LCDs) set forth by the Medicare Administrative Contractor (MAC) in your specific region. Each MAC may have specific guidelines or requirements that must be met for the service to be considered reimbursable.
Therefore, it is crucial for healthcare providers to verify the specific coverage policies and documentation requirements with their respective MAC to ensure compliance and successful reimbursement for CPT code 93660.
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