Modifier 51 with cath/stent

dhusby

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Help! Our claim scrubber is saying that the new cath codes need a modifier 51 when billed along with a stent. However, I do not feel this is appropriate. Opinions, anyone???
 

Jim Pawloski

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Help! Our claim scrubber is saying that the new cath codes need a modifier 51 when billed along with a stent. However, I do not feel this is appropriate. Opinions, anyone???
Was this cardiac cath or an arteriogram? I think it should be modifier -59 since they are distinct procedures.

Jim Pawloski, CIRCC
 

dhusby

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Cardiac cath. And from other discussions I've seen, those that have looked at the NCCI edits feel the general consensus is that 59 would not be necessary either.
 
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