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Wiki Cardiac Catheter Bundling Question

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abishard

abishard

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Hello,

Does anyone know why UHC would be denying 93540 with 93510?

Thanks,
Amy
 
What other codes were billed with the heart cath. Was another procedure performed the same day? The reason why I ask is because UHC has denied 93540 but it was billed the same day as a stent placement. We rebilled 93540 with modifier 59 and some claims were paid.

Dolores, CPC-CCC
 
I agree with Dolores. UHC for me as well will deny if I don't have a -59 modifier on the 93545 and 93540 when there is a stent done in the same session.

Jessica CPC, CCC
 
Yes, a stent (CPT 92980) was also performed. What is their reasoning? I'm not comfortable simply appending a 59 modifier as that could be a red flag.

Thanks for any help!
 
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