CPT codes, descriptions, and other data only are copyright 2008 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.
Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyrighted by the American Dental Association. © 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.
NOTE: Should you have landed here as a result of a search engine (or other) link, be advised that these files contain material that is copyrighted by the American Medical Association. You are forbidden to download the files unless you read, agree to, and abide by the provisions of the copyright statement.
EKG, EKG Rhythm Strip, and Cardiac Echography: CCI Bundling Denials
Denial Reason, Reason/Remark Code(s)
- M-80: Not covered when performed during the same session/date as a previously processed service for the patient
- CO-B15: Payment adjusted because this procedure/service requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated.
- CPT code: 93010, 93042 and 93320
Correct Coding Initiative: The Correct Coding Initiative (CCI) packages, or 'bundles', reimbursement for some services under Medicare. CCI identifies code pairs that are never reimbursed separately and code pairs that can only be reimbursed separately in certain circumstances (identified by the appropriate modifier).
Resources
- Check CCI edits prior to claim submission; edits are updated quarterly
- CPT codes 93010 and 93042 are bundled with many CPT codes, including Percutaneous Transluminal Coronary Angioplasty (PTCA), many diagnostic procedures, and some other EKG codes
- CPT code 93320 is bundled with various codes, including CPT codes 93306, 93307, 93308 and 93018
- If these services are separate, distinct services and are marked with indicator '1' in the CCI edit list, submit CPT modifier 59. Examples of separate, distinct services include situations in which the rhythm strip was taken at a different patient encounter. Supporting documentation is required in the medical records.
- For additional, specific information on modifiers that may be used to denote exceptions to CCI (including CPT modifier 59), refer to the Palmetto GBA Modifier Lookup tool: