Wiki Non-Coronary IVUS 37252

[jdking]

Anyone else having trouble with the 37252. Our doctor usually performs when doing a Left or Right heart CATH. The 37252 doesn't pair with a CATH continues to ask for a primary code. Has anyone had any luck figuring what code to use with this.

 

[Chlrtrep]

Anyone else having trouble with the 37252. Our doctor usually performs when doing a Left or Right heart CATH. The 37252 doesn't pair with a CATH continues to ask for a primary code. Has anyone had any luck figuring what code to use with this.

I am confused on why the physician is performed non coronary IVUS procedure when doing a diagnostic cath. I would assume at some point during this procedure there was a diagnostic angiogram performed on a non coronary vessel. Or was this a follow up procedure to a diagnostic procedure of a non coronary vessel from a different encounter?

37525
Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vess

 

[jdking]

I am confused on why the physician is performed non coronary IVUS procedure when doing a diagnostic cath. I would assume at some point during this procedure there was a diagnostic angiogram performed on a non coronary vessel. Or was this a follow up procedure to a diagnostic procedure of a non coronary vessel from a different encounter?

37525
Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vess

Usually our Dr. performs this as part of a TAVR evaluation. He does a peripheral angiogram with and IVUS of the peripherals.

 

[hollomanh]

Usually our Dr. performs this as part of a TAVR evaluation. He does a peripheral angiogram with and IVUS of the peripherals.

Every single one we've billed to Medicare so far this year has denied for this bogus denial of needing a valid primary CPT. It's part of a TAVR workup for us as well. The codes it's being billed with are no different than when done in 2015. But something changed with this new code. Per CMS, the add-on codes are set by the MAC for this code and, of course, our MAC is Palmetto and they will not release this list. Upon appeal, they still deny it stating they are missing a primary code, yet the don't give further information. I'm waiting for the second level appeals to review to see if we get anywhere. Very frustrating especially when we can have the same set of primary codes billed last year with the old IVUS codes and they processed and paid just fine......