Wiki Cardiac Catheter Bundling Question

[abishard]

Hello,

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

Thanks,
Amy

 

[deeva456]

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

 

[Jess1125]

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

 

[abishard]

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!