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Wiki Phys Group A vs Phys Group B

Thread starter mbprzychocki
Start date Jul 12, 2013

Create Wiki

mbprzychocki

Contributor

Jul 12, 2013

When a Cardiologist from Phys group A does a heart cath (93458 - primary procedure code) and calls in a provider from Phys Group B to do add'l work such as a FFR (93571) or IVUS (92978) - add on codes.
We are getting denials from the payer because the Providers are not in the same group. How does 1 provider in 1 group bill for the primary procedure and the other provider bill for the interventional work that is a add-on code?

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