Outpatient Echocardiography for Myocardial Perfusion Services Denying in Error


Outpatient Echocardiography for Myocardial Perfusion Services Denying in Error
Date  
4/1/2021 Update Status: Palmetto GBA continues to isolate claims affected by this processing issue. In addition to CPT Code 93306, the CPT Codes 93307, 93308, 93350 and 93351 are also incorrectly denied with reason code 55503. We will initiate a mass adjustment for claims submitted on or after 2/7/2021, once this issue has been corrected.
Provider Action: Palmetto GBA is recommending providers hold current claims until we have resolved the issue.  
3/18/2021 Status: CPT Code 93306 is listed in LCD articles A58503 and A55625. CPT 93306 edits with medical denial reason code 55503 for LCD article A58503, for various ICD-10-CM codes but these combinations are payable under LCD article A55625.
Provider Action: Palmetto GBA is recommending providers hold current claims until we have resolved the issue.  
3/16/2021 Issue 
Some outpatient hospital claims (13x type of bill) that reported Echocardiography CPT 93306 on or after Feb 7, 2021, were denied in error with reason code 55503 citing LCD 38786 – Echocardiography for Myocardial Perfusion. Palmetto GBA isolated the processing issue and will initiate a mass adjustment for claims submitted on or after 2/7/2021, once the issue has been corrected.

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Last Updated: 04/01/2021