Wiki 93571

[bennieyoung]

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?

 

[Jim Pawloski]

Are you adding a vessel modifier to 93571, as in 93571-LD?
HTH,
Jim Pawloski, CIRCC

 

[carelitz]

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)

 

[bennieyoung]

Are you adding a vessel modifier to 93571, as in 93571-LD?
HTH,
Jim Pawloski, CIRCC

I am coding 93458 - 26,59 and 93571 - 26, LD
It's denying saying it's not seperately billable.

 

[bennieyoung]

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 added a 59 to the 93458 is the only difference. the denial says not separately billable.

 

[Jim Pawloski]

I would be appealing this, and tell them that 93571 is an add-on code, and the base code is 93458.

 

[bennieyoung]

I would be appealing this, and tell them that 93571 is an add-on code, and the base code is 93458.

Thanks! That was my first thought but it made me hesitate when it wasn't just one denial... it was several of them. Thanks again!

 

[ldickerson58]

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.

 

[bennieyoung]

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.

thank you!

 

[empalagiglass]

Hi all,
Hoping someone can help with this again. I am billing 93458-26 along with 93571 26, 59, LD and UHC is still denying.

 

[camillecoder@hotmail.com]

UHC - that's your answer. UHC is Voldemort

 

[l.chriss@trajectoryrcs.com]

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.