Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > Cardiology
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 05-19-2011, 07:46 AM
coders_rock! coders_rock! is offline
Expert
 
Join Date: Apr 2007
Posts: 406
coders_rock! is on a distinguished road
Question 36140,36247,37224,75716,75625 denied

93458(26) - PAID
37225 - PAID
37224 - DENIED - bundled to 37225 but a modifier is allowed
36247 - DENIED - bundled to 37225 but a modifier is allowed
36200(59) - DENIED - bundled to 93458 no modifier allowed
36140 - DENIED - bundled to 37225 but a modifier is allowed
75716(26/59) - DENIED - bundled to 37225 but a modifier is allowed
75625(26) - DENIED - bundled to 93458 but a modifier is allowed

I received these denials but do not have a report, can anyone determine if any of these are eligible for reimbursement. If truely bundled, how so?

Thanks!
Reply With Quote
  #2  
Old 05-19-2011, 01:29 PM
deeva456 deeva456 is offline
Expert
 
Join Date: Apr 2007
Posts: 252
deeva456 is on a distinguished road
Default

93458(26) - PAID
37225 - PAID
37224 - DENIED - bundled to 37225 but a modifier is allowed
36247 - DENIED - bundled to 37225 but a modifier is allowed
36200(59) - DENIED - bundled to 93458 no modifier allowed
36140 - DENIED - bundled to 37225 but a modifier is allowed
75716(26/59) - DENIED - bundled to 37225 but a modifier is allowed
75625(26) - DENIED - bundled to 93458 but a modifier is allowed

I received these denials but do not have a report, can anyone determine if any of these are eligible for reimbursement. If truely bundled, how so?

Thanks!

Cannot give the correct codes w/o the report;however cannot bill 36200 & 36140 if a selective injection (36247) was done. Always bill selective over non selective codes. Was 32774 & 32775 performed in the same vessel? If so, 32775 includes angioplasty and atherectomy in the femoral/popliteal vessel.

Hope this has helped.

Dolores, CCC - CPC
Reply With Quote
  #3  
Old 05-23-2011, 12:15 PM
Jim Pawloski Jim Pawloski is offline
True Blue
 
Join Date: Apr 2007
Location: Ann Arbor
Posts: 755
Jim Pawloski is on a distinguished road
Default

Quote:
Originally Posted by coders_rock! View Post
93458(26) - PAID
37225 - PAID
37224 - DENIED - bundled to 37225 but a modifier is allowed
36247 - DENIED - bundled to 37225 but a modifier is allowed
36200(59) - DENIED - bundled to 93458 no modifier allowed
36140 - DENIED - bundled to 37225 but a modifier is allowed
75716(26/59) - DENIED - bundled to 37225 but a modifier is allowed
75625(26) - DENIED - bundled to 93458 but a modifier is allowed

I received these denials but do not have a report, can anyone determine if any of these are eligible for reimbursement. If truely bundled, how so?

Thanks!
Again, with no report, I can't be positive with these codes. But this what info. I can give you.
37225 - Atherectomy W/ ANGIOPLASTY
37224 - Angioplasty (bundled into 37225) - no modifier
36247, 36200, and 36140 - These charges are canceled with the interventional code. Read the second paragraph of page 208 of the CPT book which will explain why.
75716 and 75625 are billable with modifier -59, if the catheter was placed at the level of the renals and the renal arteries are described. Then the catheter must be pulled down to the iliac bifurcation to be able to bill for the extremity angio using two charges. If the catheter was placed at the renals and all imaging was performed from there, then you have to use 75630. If the catheter was placed at the distal abdominal aorta, then you can onlt bill for the extremity angio.
HTH,
Jim Pawloski, CIRCC
Reply With Quote
  #4  
Old 05-23-2011, 12:42 PM
coders_rock! coders_rock! is offline
Expert
 
Join Date: Apr 2007
Posts: 406
coders_rock! is on a distinguished road
Default

Thanks Jim, I did read page 208. Everything is clear except for the radiology codes.
Reply With Quote
  #5  
Old 03-26-2013, 12:54 PM
angelorayhurst@gmail.com angelorayhurst@gmail.com is offline
New
 
Join Date: Apr 2007
Posts: 1
angelorayhurst@gmail.com is on a distinguished road
Question Need help on the vascular coding please, going crazy

I don't have the reports but Medicare denied the below. Can anyone help me determine why?

36870 59: Denied bundled
35476 59: Denied bundled
75978 26 59: Paid
35475 59: Denied bundled
75962 26 59: Paid
75710 26 59: Paid.

Also can you tell me where I can find the primary procedures to these codes?

Thank you!!!
Reply With Quote
  #6  
Old 03-26-2013, 02:00 PM
dpeoples dpeoples is offline
True Blue
 
Join Date: Apr 2007
Location: Birmingham, Alabama
Posts: 844
dpeoples is on a distinguished road
Default

Quote:
Originally Posted by angelorayhurst@gmail.com View Post
I don't have the reports but Medicare denied the below. Can anyone help me determine why?

36870 59: Denied bundled
35476 59: Denied bundled
75978 26 59: Paid
35475 59: Denied bundled
75962 26 59: Paid
75710 26 59: Paid.

Also can you tell me where I can find the primary procedures to these codes?

Thank you!!!
The codes that you show as denied are primary procedures. You say they are bundled, what did they bundle with? Are there other codes that were used as well? Was this one case/session? Is it a dialysis graft procedure? If so, did you code 36147?
Perhaps you can provide the report?

__________________
Danny L. Peoples
CIRCC,CPC
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 12:54 AM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC