Question cardiology add on code 37253

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Having an issue getting paid by Medicare for cpt 37253 when billing over 5 units, this is an add on code and cannot use a modifier. billing 37252 with 37253
going through the main abdominal artery however the 37253 is for both Rt and Lft. Does it always require reconsideration to exceed the frequency? New to Cardiology coding.
 

karenkostecki

Networker
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the MUE on CPT 37253 is 5 so that is why you are having issues with units over this quantity. It has an MAI indicator of 3 though which should be able to be appealed with clinical documentation of the excess units (which it sounds like you are already doing). Hope this helps!
 
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