General Surgery Coding Alert

Question: In addition to billing 33533 (coronary artery bypass, using arterial graft[s]; single arterial graft) and 33517 (coronary artery bypass, using venous graft[s] and arterial graft[s]; single vein graft [list separately in addition to code for arterial graft]), we would like to bill 92978 (intravascular ultrasound [coronary vessel or graft] during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel [list separately in addition to code for primary procedure]) and 92979 (each additional vessel). The hospital will bill for the technical component. How can we bill for 92978 and 92979?

Benny DeArce
University of Miami School of Medicine

Answer: According to the Medicare Physician Fee Schedule, 92978 and 92979 have a professional and technical component included, says Kathy Zmuda, CPC, lead inpatient coder for CIGNA Healthcare in Peoria, Ariz. To gain reimbursement for performing these services, append modifier -26 to indicate that you have performed the professional portion only.

Note: The 2000 National Medicare Physician Fee Schedule Relative Value Units Guide can be downloaded at: http://www.hcfa.gov/stats/pufiles.htm#rvu.