Medicare denying 37252

priedel

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Hey y'all,

I have 2 cases where Medicare is denying 37252 saying there is no valid primary code. One primary code is 36245 and the other is 36252. Both are primary procedure of placing the cath in the leg and the renal artery however Medicare is denying the IVUS because they are saying there isn't a valid primary code.

Has anyone else had trouble with this? If these aren't primary codes, what would exactly be a primary code for an IVUS done during a cath of the legs and renal?

Thanks for any help!

Trish
 

hollomanh

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I'm curious if your noncoronary IVUS 37252 was ever paid. Since this code began in 2016, we have had problems with our local MAC not accepting selectives as the primary procedure. I've emailed their provider rep to see if they'd consider letting us know what they consider valid since it seems like nothing works at the first level. Just wondered if anyone was still having this issue...

Heather
 

priedel

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Gerrardstown, WV
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I had to put in a call to the company that produces the IVUS device and they looked into it. The person I spoke with said there was no valid reason to deny it because both the primary codes I was using were correct so I got a letter from the company saying this was valid and had to resubmit it. So far I have not gotten a denial back.

Trish
 

tinaleslie

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IVUS denial

Just curious if anyone figured out how to get 37252 paid. I am using primary code 37236,37252-26 and 36245.
Any thoughts?
 
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