Wiki Claim denied

[2210kelly@gmail.com]

I have a claim that is denied processing because of CCI edits. The physician from the left approach placed a temporary pacer and IABP, from the right approach a coronary heart cath was done, patient was taken emergently to cath lab due to cardiogenic shock and bradycardia. I coded claim...33210. 33967, 36200 and 93454. So 33210 can not be presented for payment with 33967 and 93454 and 36200 can not be presented for payment with 93454. So even though this was an emergent situation the temporary pacer can not be billed at all? And the separate stick can not be billed?

 

[Jim Pawloski]

I have a claim that is denied processing because of CCI edits. The physician from the left approach placed a temporary pacer and IABP, from the right approach a coronary heart cath was done, patient was taken emergently to cath lab due to cardiogenic shock and bradycardia. I coded claim...33210. 33967, 36200 and 93454. So 33210 can not be presented for payment with 33967 and 93454 and 36200 can not be presented for payment with 93454. So even though this was an emergent situation the temporary pacer can not be billed at all? And the separate stick can not be billed?

36200 is bundled with the heart cath. Was there an intervention? Temporary Pacemaker is not allowed with an intervention to the RC. But I would try a modifier -59 or xs for 33210 and 33967.
HTH,
Jim Pawloski, CIRCC

 

[2210kelly@gmail.com]

No intervention. Patient had intervention the day before. Physician was just checking vessels all was clear but pacer, balloon pump and intubation were applied.