denials for CPT 36010

[Kcronin1122]

Hi all,
I am getting alot of denials for CPT 36010 for bundling. Is anyone else having this issue?

 

[AmandaBriggs]

It would be helpful to know what you're billing this code with. If you're coding it along with a heart cath, then it is inherent to the procedure and should not be reported separately. Per both CPT and the NCCI manual, the heart cath codes all include the work of accessing and selectively catheterizing the vessel.

 

[Kcronin1122]

So if I am billing 93531 and 36010 together it’s bundled?

 

[SharonCollachi]

So if I am billing 93531 and 36010 together it’s bundled?

93531 Combined right & retrograde left heart cath for congenital cardiac anomalies
36010 Introduction of catheter, superior or inferior vena cava

Yes, that's what she is saying.

 

[AmandaBriggs]

Here is from the NCCI manual, "A number of diagnostic and therapeutic cardiovascular procedures (e.g., CPT codes 92950-92998, 93451-93533, 9360093624, 93640-93657) routinely use intravenous or intra-arterial vascular access, routinely require electrocardiographic monitoring, and frequently require agents administered by injection or infusion techniques. Since these services are integral components of the more comprehensive procedures, codes for routine vascular access, ECG monitoring, and injection/ infusion services are not separately reportable."
https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd
And from CPT, "Cardiac catheterization is a diagnostic medical procedure which includes introduction, positioning and repositioning, when necessary, of catheter(s), within the vascular system..." (CPT 2020, p679).