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Can anybody decode medical codes?

Discussion in 'Off Topic Threads' started by Bisi, Apr 25, 2013.

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  1. Bisi

    Bisi TS Member

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    Back in early March I went in for an echogram and nuclear stress test. It had been 5 years since my last test and the cardiologist thought I should have another. The test this time was 4 times higher than back in 08. I was shocked by the bill, and asked for a detailed medical bill. Finally received one from them today. I just had 2 tests: echo, and nuclear stress test. They are billing me for 4 items. Can anyone decipher it for me?

    93306 ECHO CO $2455.00

    93017 STRESS $1015.00

    A9500 SESTAMI $1448.00

    78452 CARDIAC $5379.00

    This was their detailed bill. Doctor billed separately. Called my insurance company to see if they could explain codes , but after 3 calls to them and getting 3 separate people with limited English in the Philippines...........

    I "googled" the codes above and still can't make sense of it. I only had 2 tests done, wonder why I'm being billed for 4? I'm going to stop by at hospital billing and ask them, but I want to have some idea of what the above codes mean before I met with them.

    Thanks in advance.
     
  2. deercreek

    deercreek Well-Known Member

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    I work in the medical field for 24 yrs now and 19 for my wife. We both work in hospitals and it is just as confusing for us. Many times when just a couple tests are ordered, others get done too because of possibly "what they noticed" during the other tests. Your provider (meaning the hospital or office which completed the procedures) is required to give you a more detailed printout and explain it till you understand it. The first three sound very reasonable and is what I would expect for what you say was ordered, but I am not sure about the last one unless you were admitted for a day.
     
  3. joe kuhn

    joe kuhn Furry Lives Matter TS Supporters

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    Those must be the procedure codes. They're out there as a standard of the industry. Will see what I can find, but youur focus on the hosp billing dept is right on.
     
  4. thomaslea1

    thomaslea1 Member

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    Maybe

    http://www.supercoder.com/cpt-codes/?gclid=CO3GpOCi6LYCFVN0MgodLlkAGQ

    It's a pay site but will give you 14 day free access.
     
  5. HSLDS

    HSLDS Well-Known Member

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    The internet is your friend...

    http://www.findacode.com/hcpcs/a9500-technetium-tc99m-sestamibi-diagnostic-per-study-hcpcs-code.html

    The SESTAMI looks to be for a nuclear isotope study (most likely looking for damaged heart muscle). (http://www.nlm.nih.gov/medlineplus/ency/article/007201.htm)

    The others don't show up so clearly.

    The ECHO - is most likely for an echocardiogram. (http://www.webmd.com/heart-disease/echocardiogram)

    The STRESS - I would assume is a stress test - did you walk on a treadmill to a 'near death' experience? (http://www.webmd.com/heart-disease/guide/stress-test--(dupe))

    The CARDIAC - well, that's a can of worms that could cover any and everything to do with the heart. Might be a seperate fee for the lab and set up, or even for the MD...

    From what I read they might be combining the stress test and the Sestamibi test into one process, but they might bill for both.
     
  6. Leafcutter

    Leafcutter Member

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    My lady worked for a medical insurance company for many years and may have the information you're looking for. Hope this helps.
    93306 - Echocardiography (a sonogram of the heart) transthoraci (through the thoracic cavity or across the chest wall)real-time with image documentation

    93017 - Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report

    78452 - Myocardial perfusion imaging (scan is a nuclear medicine procedure that illustrates the function of the heart muscle)

    The A9500 code she's not familiar with.
     
  7. Shootrman

    Shootrman Member

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    I know when I was in a hospital and got my bill I had Doctors I never heard of charging me for thing I didn't even know about. It seems if a Dr just looks into ur room as he walks down the hall, YEP, you guessed it....... Pay the man!
     
  8. James344

    James344 Active Member

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    My wife has been an ICU Nurse for 20 years, as well as certified in Critical Care and Advance Cardiac Life Support. She tells me that is typical billing for the tests you had done. Hope everything is okay.
    Jim
     
  9. Remstar311

    Remstar311 Member

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    I just googled A9500 and it looks like its for the Technetium which is the radioactive isotope that they injected you with for the imaging portion of the test (when you were laying under that big camera).
     
  10. Bisi

    Bisi TS Member

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    Thanks guys for taking the time to help. I know you got other things to do.

    What po me is I have canceled checks for the same test done in 06, and 08. The total cost then was $1302.08, and $1619.07 respectively. The insurance got me a “discount” to bring the bill down to around $6000 this time, but I gotta pay that because of the high deductible. And with what insurance premiums are you would think the insurance co. could hire people in the USA who speak English instead of locating their customer service center in the Philippines. “Hey Joe, you got questions, I help you” Is about the limit of their vocabulary I could understand.

    Thanks again.
     
  11. likes-to-shoot

    likes-to-shoot Well-Known Member

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    I've had stress tests every year since 1990......my self pay now is more than the whole test was in 90......What hasn't gone up??? The medical field is about the only business that is allowed to go rampant on price increases.
     
  12. wrzone

    wrzone Member

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    If you call a service center and they are located in another country all you have to do is tell them you want to speak to someone from the USA they have to transfer call it is the law.

    The first question I ask when I call a service center whether they can speak good english or not is if they are in USA if they are not I tell them to transfer call to USA it is that simple and keeps jobs in here.
     
  13. senior smoke

    senior smoke Well-Known Member

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    I recently went through the same thing. I talked to some guy in India and could not understand a word he said. I asked to speak to his supervisor and this guy was no better.

    I some times think companies want it this way so you get tired of calling and hopefully you will go away.

    In my situation, I thought I was done paying all these inflated medical bills until I received another bill almost one year later from a doctor who consulted on my medical problem.

    Good luck to you,
    Steve Balistreri
     
  14. X Trap 2

    X Trap 2 TS Member

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    Good information. One learns to get a cost BEFORE the service is done.

    I got a stress test in about 1994. My doctor sent me to a hospital. I had to pay rent for the room. I had to pay the nurse that stood there and watched. I had to pay the heart doctor to stand and watch while I was on the treadmill. There was a regular doctor there also that I had to pay.

    I had to write a check to each before they would proceed.

    I was a cash customer with no insurance.I asked why the hospital did not just bill me or let me write one check and was told they might not be there the next week and wanted to get payed. They were independent contractor type of service. I told them I only had one check left so keep that in mind.

    Seems as all together it was $1200.00 and all it was, was a stress test on a tread mill.

    They said it looks as you will go the distance. I asked what he meant. He said as they speed up and elevated the tread mill my heart rate stayed low and that was good. I talked the whole time while on the machine. All was OK and may not necessary. Ray
     
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