Wiki Heart cath and Renal Selective

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Melonyw

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I am unsure of the modifiers I am supposed to be using.


I am just going to give and example of a heart cath and renal selective procedure done, I am new to cardio coding :) so very interesting!!

Lets say the doctor did:

R&L heart cath
Inj proc LVG
Inj Proc AOG
Inj Proc COR
S&I LVG
S&I COR
Coronary Stent in Left decending
IVUS coronary single
DIAG Cath Placement Renal
Renal selective:bilateral

Would the coding be this?

93526-26
93543
93544
93545
93555-26-59
93556-26-59 would I use the modifier 59 because there was a stent placement? If there was not a stent placement I would not use the modifier 59 is that correct?
92980-LD
92978 not sure if this needs a modifier or not?
36245-59 not sure on this I believe I need a modifier 59 because it was done with the heart cath and stent placement but not sure!!
75724-26-59 would I use the 59 on this?

One more example:

On this one there was not a heart cath at all just stent placement

INJ Proc Cor
S&I cor
Coronary stent to right coronary
cath placement renal
renal selective unilateral

So my codes for this is:

93545
93556-26-59
92980-RC
36245 would I use the modifier 59 since there was stent placement?
75722-26

I look at this so much I make myself confussed. Thank you for helping in my time of losing my mind in the world of Cardio :D
 
You are fairly close to using the correct codes, dont need some of the modifiers.
#1
92980 - no modifier
93526-26
93543-51 (some payers may require modifier 51)
93544
93545
93555-2659
93556-2659

36245-59
75724-26-59


#2 Coronary stent

Code only 92980. 93545 & 93556-26 cath placement and imagind is bundled with 92980 and cannot code separately unless the heart cath was done first and the doctor discovered the occlusion, lesion etc and decided to do the stent. otherwise bill as follows:

92980 - no modifier
36245-59
75722-2659 ( is this a unilateral study?)

Only use modifiers on 92980 if stents are placed in more than 1 coronary artery; RC, LD or LC. example 92980-RC 92981-LC.

I hope this helps to lessen your confusion. :)

Dolores, CPC,CCC
 
Thank You Dolores :D

Would I use a 59 modifier on 36245 and 75722 or 75724 if there was no intervention placements and just a hearth cath done?
 
hI,

Yes, you would use modifier 59 on 36245, 75722 & 75724 if billed with
only a heart cath and it is a renal selective catheter placement.

Dolores, CPC,CCC
 
The 93526 would be reported with a -26 modifier because the above case is taking place in a facility that will report the technical component and we would only be reporting for the professional component.

Jessica CPC, CCC
 
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