Wiki DFR/IFR 93571-26-52-(vessel modifier) IS ANYONE GETTING PAID??????

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cweavercpc

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Is anyone actually getting paid for billing DFR's 93571-26-52-ld billed with a heart cath? We are getting zero payment and repeatedly denied for our "non specific" comment for modifier 52. We are under Palmetto GBA.
So far we have tried these 2 comments:

* IVUS coronary flow reserve measurement during coronary angiography without the use of pharmacological stress agent
* Modifier 52 was reported based on the CPT book description whereas all criteria were not met. The service was performed without the use of pharmacological agent indicating that a reduced level of service was provided



What do they want?!?!?!?!?!?!?!?! Any feedback is appreciated!!
 
We do usually get paid for this. This is the note that we put on the line item for 93571-26-52-ld:
" Modifier 52 added due to no pharmacological induced stress involved in this care. "
 
Hi
I was trained years ago that using modifiers 22, 52, 53 means most send documentation. Do you think this is the problem?
Lady T
 
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