1formissy
Guru
I am auditing an operative report and am confused on part of the documentation/coding that I hope someone can help.
The claim was billed in this manner.
92928
93458-26, 59
92921
75736-26
The provider has come back and appealed the CPT code 93458 which I originally denied because it was bundled with CPT code 92928. According to the provider, the code is separately reimbursed because the patient did not have a diagnostic cath before.
I reviewed the CPT book, and it does day diagnostic angiography perofrmed at the time of a coronary interventional procedure may be separately reportable if:......no prior cath-based coronary angiogprahy study is available....
However, I noticed as reading before that part of the CPT book, it says diagnositc coronary angiography code 93458-93461 should NOT be used with percutaneous coronary revascularzition services 92920-92944 to report...and so on.
I really need someone who is experienced in coding these cases to provide me some insight on what is appropriate reporting.
Thank you in advance
The claim was billed in this manner.
92928
93458-26, 59
92921
75736-26
The provider has come back and appealed the CPT code 93458 which I originally denied because it was bundled with CPT code 92928. According to the provider, the code is separately reimbursed because the patient did not have a diagnostic cath before.
I reviewed the CPT book, and it does day diagnostic angiography perofrmed at the time of a coronary interventional procedure may be separately reportable if:......no prior cath-based coronary angiogprahy study is available....
However, I noticed as reading before that part of the CPT book, it says diagnositc coronary angiography code 93458-93461 should NOT be used with percutaneous coronary revascularzition services 92920-92944 to report...and so on.
I really need someone who is experienced in coding these cases to provide me some insight on what is appropriate reporting.
Thank you in advance