Recently had a case where the a patient had a left heart catheterization, angioplasty of proximal obtuse marginal branch, Pelvic angiogram and intravascular ultrasound of saphenous venous graft to right coronary artery. After performing the angioplasty there was still a significant residual stenosis w/calcification so the provider performed a shockwave lithotripsy but did not place any stents. The codes we billed were 92937.LC, 92972, 92978.LC, 93459.XU with supply codes of C1725, C1753, C1761. We are receiving a rejection from Medicare says claim with pass through device, drug or biological lacks required procedure for the C1761. We found this transmittal from CMS indicating that C1761 should always be billed with 92928, C9600m C9602 and C9607. https://www.cms.gov/files/document/R11004CP.pdf#page=13. But the provider did not do any of those procedures listed.
My question is having anyone had this happen before with a provider and if so, how did you handle the billing of this?
My question is having anyone had this happen before with a provider and if so, how did you handle the billing of this?