Wiki Cath and stent

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coding?4u

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I have a diagnostic cath and then a stent during the same session. Only the stent was provided by the interventionalist. I am having trouble billing the stent without a cath code. Could I bill 93508 with mod 52 since the 93508
along with the angiography and S&I codes were billed by the physician billing for the diagnostic cath? We run into this sometimes as some of our
physicians are not trained to do the intervention. Thanks for any advice.
 
We also have doctors that do not do stents. We code the cath under the doctor that did the cath and then the doctor that did the stent bills for the stent. For example if Dr. A did a left heart cath we code:

93510/26
93555/2659
93556/2659
93545
93543

Dr. B does the stent so we code:

92980/ld, rc or lc

Hope this helps!
 
Suggestion

If you bill the stent with the cath shouldn't you add -59 to the two imaging codes, 93555 and 93556?
 
cath and stent billing

I agree with above. The 59 modifiers indicated in her example are correct.
 
I agree with the 59 and just left it off. My problem is that my system will not allow me to bill a 92980 without a cath code. Since the diagnostic cath was done by someone other than the interventionalist. If I just force the claim out, I wonder if it will be denied by the carrier for the cath? I have been billing a second cath code and using Mod 52. He has to use a cath to put the stent in anyway. I'm beginning to think from the above example that I need to force this claim out?
 
Sounds like you will have to force it out because the interventionalist isn't going to be able to bill for any catheter placement code with the stent. The work of placing the guidewires and catheters for use during the stent is going to be included in payment for the 92980.

Jessica CPC, CCC
 
Caths and stents

If the catheter is still in place and the stent is done soon after the heart cath, I code the stent only. It gets paid. If the cath is removed and the stent is done (i.e. days later), I bill 93508-26, 58 for staged and the stent.
It also gets paid. You have to look at each circumstance.
 
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