Wiki 36005 denied

[coders_rock!]

Good morning all,

My Dr. billed,

33249
33225(53)
71090(26)
36005

Everything was paid except 36005. I've been receiving a lot of denials bundling 36005 into 33249. Can you help explain what they know about billing 36005 with 33249?

Thank you very much!

 

[Jim Pawloski]

Good morning all,

My Dr. billed,

33249
33225(53)
71090(26)
36005

Everything was paid except 36005. I've been receiving a lot of denials bundling 36005 into 33249. Can you help explain what they know about billing 36005 with 33249?

Thank you very much![/QUOTE

It is bundled into the pacemaker insertion along with the venogram, unless stenosis is found in the venous system before insertion.

HTH,
Jim Pawloski, CIRCC

 

[coders_rock!]

Thanks Jim, I sent you an email on 10/21, did you receive it?

 

[Jim Pawloski]

Thanks Jim, I sent you an email on 10/21, did you receive it?

No I did not. What was it about?

Jim

 

[coders_rock!]

I wanted ur opinion regarding an cardiac-catheterization report, if you're familiar with it.

 

[maryawinfield04]

You can add a (59) modifier to the 36005 procedure code and rebill it. you can also check www.supercoder.com when you're coding procedures. I hope this helps

 

[theresa.dix@tennova.com]

You can add a (59) modifier to the 36005 procedure code and rebill it. you can also check www.supercoder.com when you're coding procedures. I hope this helps

Oops don't add 59 modifier unless you have medical necessity.A "good dx".

If a full and complete diagnostic subclavian venogram is performed report it separately with 36005 and 75820. Code 36005 may need 59 modifier attached. If Venogram is done to establish vein patency or roadmapping purposes 36005 and 75820 should not be reported.

 

[maryawinfield04]

Oops don't add 59 modifier unless you have medical necessity.A "good dx".

If a full and complete diagnostic subclavian venogram is performed report it separately with 36005 and 75820. Code 36005 may need 59 modifier attached. If Venogram is done to establish vein patency or roadmapping purposes 36005 and 75820 should not be reported.

of course if the diagnosis is of medical necessity.