Wiki 93508 and 93510 on the same day

[jtuominen]

Hi there--

I am getting a denial for a patient that had two caradiac catheterizations in one day. In the morning he had a diagnostic left heart cath 93510 followed by a stent placement. In the afternoon he had a Coronary angio 93508 after some worry that he may have stenosed again. I am getting a denial on the 93508. I put a -59 on the 93508 but still am getting the denial. Here are the codes I billed out:

For the AM:
93510
93543
93545
93555
93556
G0290-LC
93571

For the PM:
93508-59
93545-59
93556-59

Any thoughts on what I should do? Should any changes be made? please help! Thanks!

 

[dpumford]

Hello! You may have to send report to prove medical necessity but also mod 78 may be needed because it was done on the same day as primary cath.

 

[ARCPC9491]

Was this staged? You might try 58 modifier.... but you're probably going to have to appeal with the records....

Good luck!

 

[jtuominen]

Thanks so much for the help. I think we are going to try to 78 and be ready to provide a report. It was not a staged procedure. The AM procedure was scheduled as a diagnostic cath that ended up needing a intervention as well after study of the findings. The PM cath was done after the patient left the cathlab and began to have chest and arm pain while on the floor. So they brought him back to check for stent thrombosis. Thanks so much for the thoughts. I am so happy that this forum is available!