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Wiki Modifier 51 with cath/stent

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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???
 
dhusby said:
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???
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Was this cardiac cath or an arteriogram? I think it should be modifier -59 since they are distinct procedures.

Jim Pawloski, CIRCC
 
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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