I have been billing for a nephrologist for over 2 years now, and he does some time in the ICU also. He will insert a tunneled cath (36558) for dialysis in the hospital, as well as attend to the dialysis (90935/90947). I have been billing these codes together for over 2 years and never had a problem.
All of a sudden, Blue Cross is denying the dialysis codes stating it's in the global of the cath insertion. I understand the 36558 carries a 10 day global, but I would expect denial for an E/M. Not the dialysis being perfomed because of the cath insertion. How is my doc suppose to do the dialysis without the cath? BCBS is telling me to modify every dialysis code I bill for 10 days after the insertion. I have appealed this because even Medicare tells me I don't need a modifier. BC came back stating i need the modifier. I took it to provider relations, told them Medicare doesn't require a modifier. They told me i still need it.
Has anyone else had to deal with this?
Bridget
All of a sudden, Blue Cross is denying the dialysis codes stating it's in the global of the cath insertion. I understand the 36558 carries a 10 day global, but I would expect denial for an E/M. Not the dialysis being perfomed because of the cath insertion. How is my doc suppose to do the dialysis without the cath? BCBS is telling me to modify every dialysis code I bill for 10 days after the insertion. I have appealed this because even Medicare tells me I don't need a modifier. BC came back stating i need the modifier. I took it to provider relations, told them Medicare doesn't require a modifier. They told me i still need it.
Has anyone else had to deal with this?
Bridget