Wiki Nephrostogram a few days later?

[SienTC1720]

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?

 

[Jim Pawloski]

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