Wiki Cardiac Caths 2011

[sslater]

Before i confuse myself anymore.. I wanted to make sure i had this correct.. Our Docs do the heart caths at the hospital. Up until this year i would bill out for ex: a L Hrt Cath, LV, w/o root as 93510-26, 93543, 93545, 93556-26 and 93555-26. This year it is just a 93458, but do i still use the -26.. The more i read the code the more confused I have gotten. Just wanted to see how everyone else was doing it. Thanks!!

 

[agott]

Yes you do use modifier -26. I just viewed a MGMA webinar and per the presenter was Terry Fletcher, per the documentation from her "Modifier 26 is required on the catherization codes for professional component billing".
Hope this helps
Autumn CPC, CCC

 

[jseda]

Before i confuse myself anymore.. I wanted to make sure i had this correct.. Our Docs do the heart caths at the hospital. Up until this year i would bill out for ex: a L Hrt Cath, LV, w/o root as 93510-26, 93543, 93545, 93556-26 and 93555-26. This year it is just a 93458, but do i still use the -26.. The more i read the code the more confused I have gotten. Just wanted to see how everyone else was doing it. Thanks!!

I would say yes, use mod 26 as the hospital owns the equipment and support staff.:

 

[jseda]

Before i confuse myself anymore.. I wanted to make sure i had this correct.. Our Docs do the heart caths at the hospital. Up until this year i would bill out for ex: a L Hrt Cath, LV, w/o root as 93510-26, 93543, 93545, 93556-26 and 93555-26. This year it is just a 93458, but do i still use the -26.. The more i read the code the more confused I have gotten. Just wanted to see how everyone else was doing it. Thanks!!

I would say yes, use mod 26 as the hospital owns the equipment and support staff, therefore doctor is only entitled to professional component of procedure: