Wiki Intravascular US

reac2005

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We have a Interventional Cardiologist who is being called in to do a intravascualr ultrasound after another cardiologist has already performed the heart cath. The only code I seen to be able to find that fit the IVUS-92978, which states; performed by the same phys as the prim proc. Our interventional cardiologist has not performed the prim proc. Does anyone have idea what other code i could look at for either the primary code or the IVUS?
 
Since 97978 is an add-on requiring 92975, 92980, 92982, 92995, 93454-93461, 93560-93533 you would have to bill it with one of those, if it was truly within a coronary vessel.

If by chance it was non-coronary then you could bill 37250/75945-26 which would not require any additional CPT code(s).

I'm not sure how to get around that. Can you have both docs on one clm and designate who did what? That's probably a stretch.
 
The only suggestion I can offer is to use the unlisted cardiovascular cpt 93799. We have only had this happen a couple times, and I don't recall if we received reimbursement. I have billed an IVUS this way, had it deny and sent in a letter explaining why I billed it that way, with a copy of the op report and the CPT guidelines. Unfortunately, I don't consistently get to see if an appeal has gotten paid or not :(. It's alway worth a try though, especially if the primary cardiologist is not in the same practice (under same tax id number) as the interventionalist!
 
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