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Ivus - billing 92978 to Medicare

Messages
192
Best answers
0
I am still having difficultity billing 92978 to Medicare. I have billed 3 different ways
92978-LM
92978-26
92978-26-59 I have been denied all 3 times, does anyone have the correct way to bill the. I never had a problem untill this year Thanks Nancy
 
Messages
235
Location
Tucson
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0
I tried billing the IVUS with the anatomical modifiers last year because I thought it would be appropriate for them to know which vessel it was performed in, but they denied though as an inappropriate modifier. -59 isn't appropriate since its an add-on code. 92978-26 is correct....I'm assuming you are billing it with a primary code like the diagnostic cath or intervention because it can't billed by itself
 

Misty Dawn

Guru
Messages
167
Location
Spokane, WA
Best answers
0
I am still having difficultity billing 92978 to Medicare. I have billed 3 different ways
92978-LM
92978-26
92978-26-59 I have been denied all 3 times, does anyone have the correct way to bill the. I never had a problem untill this year Thanks Nancy
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Hi, use 92978 one time for intial vessel and then 92979 for any additional vessles.

92978
92979-59
92979

From 2013 CPT reference guide: Add on code 92979 is used to report the ultrasound procedure on each additional coronary artery when more than one coronary artery is evaluated with intravascular ultrasound as part of a diagonstic or therapeutic procedure....
 

rpeterson

Contributor
Messages
12
Best answers
0
Ivus

Keep in mind that the IVUS code is not payable for additional vessel codes.

Robin Peterson, CPC
University Physicians Inc
QCAE Department
 
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