Wiki HELP denial

[heart123]

select-care is denying 93458,26,xu and 93571,26

they want an anatomical modifier (HUH!)

 

[heart123]

for a heart cath???
never heard of that one

 

[theresa.dix@tennova.com]

for a heart cath???
never heard of that one

NO for the 93571.

 

[setcabilling]

We are having the same problem with heart caths denied by Select Care. But we do our caths in the office and billed 93459 and 99152 for moderate sedation. They paid the 99152 but asked for the anatomical modifier on 93459. And when you call them, they know nothing. They only tell you it is per CMS guidelines, but I haven't found anything on CMS.

 

[heart123]

thanks i thought i was the only one having this problem on the cath code 93458

 

[setcabilling]

So we finally got an answer from our local reps for Select Care. They said there was a glitch in their system and they denied incorrectly. I set all of mine to refile today.

 

[heart123]

thanks

 

[bridie25]

Anatomical Modifier is requiredon 93571

So we finally got an answer from our local reps for Select Care. They said there was a glitch in their system and they denied incorrectly. I set all of mine to refile today.

Even though the cath was denied in error, 93571 still requires an anatomical modifier.