Cardiac Catherizations--93458-26 with moderate conscious sedation Denials

[tfischer]

We are billing 93458-26 with 99152 as the documentation is supportive of Moderate Conscious Sedation. 93458 is on the list of CPT codes that 99152 can be billed with. However, for the professional component only should we be billing 99152 in addition to the Cath? We are getting denials from Anthem specifically for these scenarios.

 

[theresa.dix@tennova.com]

We are billing 93458-26 with 99152 as the documentation is supportive of Moderate Conscious Sedation. 93458 is on the list of CPT codes that 99152 can be billed with. However, for the professional component only should we be billing 99152 in addition to the Cath? We are getting denials from Anthem specifically for these scenarios.

Yes you should be getting paid for these. Appeal with the records maybe they have an edit in place.