Wiki 2012 Cardiology question

[deehammond]

In 2012 I have a medical group denying some of my claims saying it is bundled. I am coding 92980-RC and 93458-26-59. They are not paying the 93458 saying it is unbundled item. Are they right?? I was told to bill both and when I read CPT I do not see that it is bundled.

 

[CathCoding]

I have been lately focused on vascular but I was coding primarily cardiology in 2012 and 93458 is bundled with 92980 but if the physician truly did a diagnostic LHC and decided to do an intervention the same day the modifier is -59 appropriate. Which you have added. I would make sure that you have not already coded a recent LHC prior to the day you did the intervention. If you have coded the 93458 within a month or so (with the same Dx) they may think you are un-bundling it inappropriately and you might have to send records and prove that the 2nd diagnostic study was warranted. (symptoms or condition has changed/worsened) I would also look and make sure it is not bumping against something else that was done with a 90 day global?