Wiki Nephrostogram a few days later?

SienTC1720

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I bill for a radiology practice, the professional component only. They placed a catheter 12/18/23, CPT 50433, the insurance paid that fine. They read and reported on a nephrostogram 12/26 as the patient had some hematuria. We used CPT 74425, which has been denied by insurance saying it needs to be billed with another procedure. We attempted to add -55 and has been kicked back again for bad modifier.

Another nephrostogram was done 1/12, same denial. The patient ended up having the catheter exchanged to upsize it, CPT 50435 on 1/16.

We get all of our charges from the facility, as they do the technical portion, so the CPT codes come from the hospital, we don't assign/change those.

Does anyone have any ideas what should be done?
 
You code 50431 for the nephrostogram, 75774 has been deleted from that charge. When an intervention has been done after nephrostogram, like a tube change, then the nephrostogram is bundled in the change.
HTH,
Jim
 
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