Wiki PERIPHERAL VASCULAR DIAGNOSTIC & INTERVENTION CODING

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mitzimarie2001@yahoo.com

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I work for a billing company and I do the medical billing for a cardiologist's professional services in a hospital setting; she sends me a copy of the Cath Lab report and she provides the CPT and diagnosis codes for the services. Many times I do not agree with the codes she provides. Below is an example of a Cath Lab procedure, and the CPT codes she provided to me. I am anxious to read your comments regarding her coding. **This is my first post on the Forum; I apologize if the formatting is off.**

1721831011624.png
These are the codes that she provided:
36140-XU
36200-XU
36246-XU
75625-26, 59
75710-26, 59
37221-LT
 
mitzimarie2001@yahoo.com said:
I work for a billing company and I do the medical billing for a cardiologist's professional services in a hospital setting; she sends me a copy of the Cath Lab report and she provides the CPT and diagnosis codes for the services. Many times I do not agree with the codes she provides. Below is an example of a Cath Lab procedure, and the CPT codes she provided to me. I am anxious to read your comments regarding her coding. **This is my first post on the Forum; I apologize if the formatting is off.**

View attachment 7204
These are the codes that she provided:
36140-XU
36200-XU
36246-XU
75625-26, 59
75710-26, 59
37221-LT
Click to expand...
Unless I missed it, I didn't see anything about an aortogram (36200 & 75625).
99152
99153 x 4
37221 (Cath placement is included)
37223
75710,26,59 (If a prior angiogram or CT angiogram was not performed)
 
Margaret, thank you for your reply. I bill for 2 cardiologists, and the difference between the two on the codes they supply for similar procedures is striking. And frustrating.

This cardiologist uses 36140-XU, 36200-XU, and either 36245-XU or 36246-XU or 36247-XU, on every peripheral vascular diagnostic & intervention she performs. She also tries to use 75625-26 and either 75716-26 or 75710-26 on every peripheral vascular diagnostic & intervention AND on every coronary diagnostic & intervention she performs. There are many other problems with her coding, as well.

About the 99152 and 99153... Whether I bill these or not, depends upon the insurance. Most of them will pay 99152, but I can only get a couple of Blue Cross plans to pay 99153. So few, in fact, that I've stopped billing it.

Thanks again.
 
99153 is for the hospital, the doctors can't code it, unless this is a OBL. Also, 36140 is bundled into 36200, 36245,46 and 47. If there is any imaging on peripheral interventions the imaging cannot be billed (can you say ROADMAPPING).
HTH,
Jim
 
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