Wiki Pulmonary Embolism

[Chelsea1]

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

 

[csperoni]

I don't code cardiology, but 37184 does allow modifier -50.
Regarding rejection with modifier -50, there are different carriers that want bilateral procedures billed differently.
Lets assume you bill $1000 for 37184 and carrier allows $600.
Some want:
37184 $1000
37184-50 $500
They will process claim and pay $600 on first line, and $300 on 2nd line.

Others want:
37184-50 $1500
They will process claim and pay $900 on the one line.

Even others may want:
37184-RT
37184-LT

If you are getting a rejection for -50 on a code that permits it, the most likely culprit is the policy of how the carrier wants bilateral procedures billed.

Hope that helps!

 

[aussome1]

When we code for EKOS the codes we use are 37211 for Arterial or 37212 for Venous and 37252 for Non Coronary Intravascular Ultrasound.

37211 Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day
37212 Transcatheter therapy, venous infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day
37252 IVUS (non-coronary vessel) during diagnostic eval/therapeutic intervention including radiological supervision and interpretation, initial non-coronary vessel.

for the bilateral use modifier 50. We have been paid without any issues. Most of the time this is an arterial procedure.