Wiki 93571

bennieyoung

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96
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Broomfield, CO
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I'm having lots of denials for 93571. I use the 26 modifier because they are done in the Cath Lab. I identify the vessel but they still deny. I usually do them with a left heart cath and I add the 26 and 59 modifier to that. What am I doing wrong? Why would these deny?
 
What is your denial stating? This will tell you what is incorrect with your FFR code.

i bill these in the hospital setting and bill:

93458 26
93571 26LD (for example)
 
I have billed several of these with heart cath and they have been paid by Medicare. The heart cath code is billed with 26 modifier only unless a stent was placed then I would use the 59 modifier also. When billing the 93571 I added both 26,59 to it for billing. Medicare has paid every time.
 
We too get denials on 93571 from United reported with modifier 26-LD in addition to billing 92928-LD. Denial reason we get is "the procedure code is inconsistent with the modifier used" I agree with above statement, United is awful.
 
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