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coders_rock!

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Can someone please help me understand these codes. Under what guidelines are they payable or not reportable? are there any resources you can direct me to read. I am lost because these codes are always being denied.

Thank you so much.
 
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Do you have an example of how you are using them, with what other codes? Also, what kind of denials are receiving?
 
coders_rock! said:
Can someone please help me understand these codes. Under what guidelines are they payable or not reportable? are there any resources you can direct me to read. I am lost because these codes are always being denied.

Thank you so much.
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If you are billing them with an intervention you'll need modifier 59 to indicate that the angiogram was a separate diagnostic exam performed prior to the intervention.

If you are billing for a physician performing the angiogram in the hospital are you adding modifier 26?

As the previous response said, what denials are you getting?
 
Here is an example:

Billed CPT codes are

36140
36247
75716
37227 - paid

Only 37227 was paid.

Here's another:

36245
75710
37226 - paid
36247
32617
36140

Only 37226 was paid.
 
37226 includes imaging. If a true diagnostic lower extremity angiogram was performed prior to the stent placement, then you need to add modifier 59 to 75710 or 75716. Catheterizations for the stent is also included in 37226. Catheterizations for diagnostic studies in vessels other than the treated extremity can be coded with -59 modifier. I note however that you are probably coding catheterizations incorrectly - or your doctor is doing a lot of separate accesses. In the first one, your codes indicate that 3 separate accesses were performed - 36140, 36247, and 37226 (since catheterization is included). The second one has several also. I suggest that you review the rules for coding catheterizations as it would be unusual to have both 36140 and another catheterization code.
 
Do you have a copy of Dr. Z? It is very helpful in understanding the do's and don'ts of IR coding. Also,, MedLearn offers some really helpful seminars if you can catch one. I recently attended one at a local hospital that was funded by Abbott labs so it was FREE! You could check Abbott's site to see if any are coming to your area. I code these types of procedures for the hospital so if you want to discuss more, feel free to contact me (tallrhon@armc.com). Stick with it, easier as you do more.
 
as a CIRCC the Z-Health IVR books are the bible for IVR coding. These books not only give you the coding rules but examples of how they are used. I highly recommend them!
 
donnajrichmond said:
37226 includes imaging. If a true diagnostic lower extremity angiogram was performed prior to the stent placement, then you need to add modifier 59 to 75710 or 75716. Catheterizations for the stent is also included in 37226. Catheterizations for diagnostic studies in vessels other than the treated extremity can be coded with -59 modifier. I note however that you are probably coding catheterizations incorrectly - or your doctor is doing a lot of separate accesses. In the first one, your codes indicate that 3 separate accesses were performed - 36140, 36247, and 37226 (since catheterization is included). The second one has several also. I suggest that you review the rules for coding catheterizations as it would be unusual to have both 36140 and another catheterization code.
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Thank you
 
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