Angiography with stent placement

mnagy4va

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Medicare has started to deny all of our diagnostic angiographies when billed in conjunction with a stent placement. We always previously appended a 26 and 59 modifier to 93555 and 93556 to indicate that this was not "roadmapping" or to assist with the intervention, however, this is no longer working and we are receiving denials from Medicare stating submission/billing error and indicating that these codes have been bundled in with the stent placement. Is there a new trick to getting diagnostic angiography paid when a stent placement is also performed?

Thanks for any help,

Melissa
 

kristenw

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Yes MC has started to deny those codes when a stent is billed but rebilling them with the 59 modifier is what you are supposed to do in this situation.
 

mnagy4va

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We are billing with a 26 for the professional component followed by a 59 modfier also when the original claims are sent for processing but we are still receiving this denial.

Thanks
 

Anna Weaver

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denials

We are also receiving denials on these. I've told the billers to appeal these, but not sure if there's something else we should be doing first. Hope someone out there has some insight!!
 

mnagy4va

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I think that this issue might be in-house. I spoke with an informative customer service representative to check if the 59 modifier was going across to Medicare and she could only see the 26 modifer. We are looking into our electronic formatting to Medicare to be sure that we are set up to send both modifier fields when indicated.

Thanks for the responses!
 
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