Wiki Modifier Help!

Create Wiki
H

hbarney1

Networker
Messages
60
Location
Allen, TX
Best answers
0
Hi,

so I received a claim with 75625 and 75716 wanting those appended with a modifier. I am looking at the NCCI edits and they had a 1 by them. When I go to the claim I am still unable to append any modifier. Is this because they are bundled? These codes were denying with HCPCS C9600. I have looked online and unable to see a website with guidelines on these codes. Cardiology isn't my strong suite when it comes to coding. Any help will be appreciated. :)
 
Hard to know what's going on without an op report but here's my 2 cents

Are you coding for the facility or the physician?

C9600 is the facility charge for a drug eluding stent placed in a coronary artery. Physician charge is typically 92928 or 92941.

75625 or 75716 would not typically be billed with a stent placed in a coronary artery.
 
espressoguy said:
Hard to know what's going on without an op report but here's my 2 cents

Are you coding for the facility or the physician?

C9600 is the facility charge for a drug eluding stent placed in a coronary artery. Physician charge is typically 92928 or 92941.

75625 or 75716 would not typically be billed with a stent placed in a coronary artery.
Click to expand...

I agree with Mark!
 
hbarney1 said:
Hi,

so I received a claim with 75625 and 75716 wanting those appended with a modifier. I am looking at the NCCI edits and they had a 1 by them. When I go to the claim I am still unable to append any modifier. Is this because they are bundled? These codes were denying with HCPCS C9600. I have looked online and unable to see a website with guidelines on these codes. Cardiology isn't my strong suite when it comes to coding. Any help will be appreciated. :)
Click to expand...

I hope you have a vessel modifier with C9600 drug eluting stent placement. You will need three modifier -59 attached to codes. First one is to the heart cath if it was a diagnostic cath and the patient didn't have one previously. The second and third modifier -59 is attached to 75625 and 75716 to show that they are separate and distinct procedures performed.

This may help you get past the NCII edit.

Jim Pawloski, CIRCC
 
You must log in or register to reply here.
Top