93000 represents an ECG with interpretation and report. Because this code represents the complete procedure, it is inappropriate to submit codes:
Another common example of unbundling is found in lab panels. 80061 (lipid panel) includes:
It would be inappropriate to bill the three individual codes to represent the panel.
Following the AMA CPT and National Correct Coding Initiative (NCCI) guidelines will ensure that claims are coded and processed correctly.
Another common coding and billing error is the correct reporting of a service unit. Always remember to verify units allowed based on CPT and NCCI guidelines. A unit is a single instance of a service.
The correct reporting of an immunization administration, CPT 90471 (includes percutaneous, intradermal, subcutaneous, or intramuscular injections);
These service(s) are only allowed once per the code description.
If you have more immunizations to code on the same claim, use code:
for each additional immunization administration given.
Another example is CPT 11100 (Biopsy of skin, subcutaneous tissue and / or mucous membrane (including simple closure), unless otherwise listed; single lesion).
The code indicates this can only be used for one biopsy. If additional biopsies are performed:
At this time, providers should report the G0515 code for all lines of business.
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