Question Pulmonary Embolism

Chelsea1

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If anyone could help please. My doctor did a bilateral EKOS for a pulmonary embolism. We got a rejection for the 50 modifier. Does anyone know if modifiers are used for those procedures? Also, can you bill for a bilateral mechanical thrombectomy? I was looking at code 37184.
Thanks for any help
 

econnolly

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CPT code 37211 has an MUE of 1 for the Professional/provider code This means that the provider can only bill 1 unit for this CPT code per day.
There are also instructions that say 37211 can be billed with a -50 modifier for bilateral procedures if the additional "infusion catheter is placed through a different/separate access site", (this instruction is a direct contradiction to the MUE 1 code status). There has been controversy about 37211 when pertaining to treatment of bilateral embolisms of the lungs, which requires placement of two separate infusion catheters. However the pulmonary catheters are often inserted through a single access site (internal jugular or femoral vein), so the procedure would not meet the code definition of separate catheter access sites.
You do have the option of sending an appeal with your procedure report attached, but so far we have not had any luck with that approach. I hope this information is helpful to you and Best of luck!
 
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