• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Carotid Angiography - modifier on these codes

Create Wiki
R

rufus

Networker
Messages
29
Location
Elkhart, IL
Best answers
0
Please Help! I am billing the new carotid angio codes 36222-36226 and they state unilateral and to use a modifier 50 for bilateral, but CMS doesn't recognize the 50 or 59 modifier on these codes. I have also looked for a LCD and NCD on these codes and can't find one. Can anyone please tell me how to bill these. We do these procedures all the time.
Thanks!!!!:confused:
 
According to Q&A session of a webinar with Dr. Z thru AAPC, he states "We NOW recommend -50 modifier per the CPT book. There has been an issue with payment system by CMS where they would not pay on the -50for MD's, however this is supposed to be fixed April 1, so you would be able to rebill the January-March cases for appropriate reimbursement." Apparently the 1st quarter CCI edits do not allow a modifier for these procedures but the 2nd quarter edits should fix the problem.

I find this whole issue to be very frustrating! I'm trying to determine what is the best way to handle these bilateral procedures and there seems to be a lot of differing opinions about which modifier to use. I personally will be going with Dr. Zs above recommendation. It will mean more work down the road, but I don't really see a way around it.
 
I also code using the new code set 36222 - 36228 and have been advised that I need to refer to LCD L31829 Table IX. Extra-Cardiac Angiography (CPT Codes 75625-75724 and 36120 - 36248) Performed during the same encounter as Cardiac Cathereterization. The issue I am having is that my Neurologist do not perform these codes 36222-36228 with cardiac caths so my claims are hitting an edit for a wrong dx code being billed. My claims not even doing past our system!! Am I right in thinking this LCD does not apply to our procedures? Please help!!!!!:confused:

I am also having the issue with the -50 on this code set.....
 
You must log in or register to reply here.
Top