Wiki Cath coding - denials for cpt codes

[apcarter]

What is it mean by 3 day payment window. Also we are receiving denials for cpt codes 93501 billed with 93505 with 26 and 59 modifier. These claims are denying as the 93505 is bundled into 93501. What would be the appropriate was of billing these codes...

The dx billed is V42.1 only...

 

[deeva456]

Hi,

I am not sure what is meant by "three day payment window". The insurance company may be holding the claim for 3 days before processing? I would call and ask what it means.
As far as billing the myocardioal bx and heart cath, it appears you are billing these two codes correctly: 93501-26, 93505-2659 and per the Medicare LCD V42.1 is a valid and billable dx; however per the ICD-9 V42.1 is considered a 2ndary dx. Depending on your Medicare carrier, you may need to bill with a primary dx and V42.1 as 2ndary.

good luck and hope this has helped.

Dolores, CPC,CCC