Wiki 37202 and 36217????

[sevans01]

Hi, Pt had vasospasm in their right internal carotid artery and this was discovered during a diagnostic cerebral angiogram. I billed for the diagnostics 36217 and the 37202. Insurance denied. My question can we bill for both?

 

[jewlz0879]

Per EncoderPro:

CCI Component

Warning: These codes may not be billed together. Check to see if a modifier is allowed and supported by documentation.

Code Description Fee FA_Total Fee Work RVU PE RVU FA_PE RVU MP RVU Total RVU FA_Total RVU Fee Type Modifier
36217 Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family $2,105.52 $344.52 6.29 54.62 2.79 1.06 61.97 10.14 Non Facility Allowed
37202 Transcatheter therapy, infusion other than for thrombolysis, any type (eg, spasmolytic, vasoconstrictive) $351.32 $351.32 5.67 3.49 3.49 1.18 10.34 10.34 Non Facility Allowed





CCI Greater PX

Warning: These codes may not be billed together. Check to see if a modifier is allowed and supported by documentation.

Code Description Fee FA_Total Fee Work RVU PE RVU FA_PE RVU MP RVU Total RVU FA_Total RVU Fee Type Modifier
37202 Transcatheter therapy, infusion other than for thrombolysis, any type (eg, spasmolytic, vasoconstrictive) $351.32 $351.32 5.67 3.49 3.49 1.18 10.34 10.34 Non Facility Allowed
36217 Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family

 

[kbazarte@yahoo.com]

you needed mod 59 on 36217 here is an example straight from Z-Health

7)Twenty-seven year old with cerebral vasospasm related to subarachnoid hemorrhage from a ruptured aneurysm is treated by catheter directed infusion therapy with verapamil (or papaverine). The catheter is placed sequentially in the right internal carotid artery and the left vertebral artery to treat these separate cerebral distributions for vasospasm (37202, 75896, 36217, 36216-59). Each treatment is for thirty minutes per vessel. Follow-up angiography (75898) is performed in each vessel treated.