Cardiology Coding Alert

Question: Our cardiologists do cardiac catheterization procedures at the hospital, not here at our clinic. As a result, we use the modifier -26 to bill these, as we cannot bill the global. We are not providing technical services, only professional. Our cardiologists think we should bill the global. Who is right?

Alana Stevens
The Corvallis Clinic

Answer: You are. For example, if the cardiologist does not own the equipment, you should append modifier -26 (which represents the professional component) to the appropriate procedural catheterization code.

Use modifier -26 with the following codes to indicate the professional component.

93501 - 93536 - right and left heart catheterization codes

93555 - Imaging supervision, interpretation and report for injection procedures during cardiac catheterization ventricular and/or atrial angiography

93556 - pulmonary angiography, aortography, and/or selective coronary angiography, including venous bypass grafts and arterial conduits (whether native or used in bypass)

Tip: Do not use modifier -26 with codes 93539 - 93545 (Injection procedure during cardiac catheterization) because they already represent only professional components. However, some carriers may specifically require modifier -26 with these codes, even though the CPT manual regards its usage as redundant. So be sure and check with your payers.