Wiki Cath and IVUS by different providers, same day

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jazzyblues2005

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We have 6 Cardiologists in our practice, one does the cath and the other does the IVUS. How do you code for this since the IVUS code (92978) is an add-on code?

Any documentation or links to support the billing would be great.

Thanks!
 
There's not much of a work around here since IVUS requires a primary code to be billed, also, it is not modifier 80 eligible. My suggestion (which is what we do): bill the primary (parent) and add-on (orphan) under physician performing diagnostic cath, then once payment is received, the physician whom performed the IVUS is paid his RVUs for the IVUS.

CPT 92978 is AS modifier elgible, so if your office had a PA or NP, then the cardiologist performing the cath could bill for cath and IVUS while the PA/NP bills 92978-AS.
 
jewlz0879 said:
There's not much of a work around here since IVUS requires a primary code to be billed, also, it is not modifier 80 eligible. My suggestion (which is what we do): bill the primary (parent) and add-on (orphan) under physician performing diagnostic cath, then once payment is received, the physician whom performed the IVUS is paid his RVUs for the IVUS.

CPT 92978 is AS modifier elgible, so if your office had a PA or NP, then the cardiologist performing the cath could bill for cath and IVUS while the PA/NP bills 92978-AS.
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Would that be legal?
 
We bill them seperately, then when we get a denial for the add on code we send an appeal indicating that the primary was already billed and they are of the same practice.
 
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