Wiki Stents CPT 92980, 92981

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jaud63

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Local Chapter Officer
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Spring Valley, WI
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We are receiving a WPS denial on both of these stents being used with the CPT 93510, 93543 and 93545. This is what our charges look like.

93510-26
93543
93545
92980
92981

The denial specifically states (denial code CO4) The procedure code is inconsistent with modifier used or a required modifier is missing.

Has anyone else received this denial? Does anyone know why different modifiers would be necessary?

Thanks
 
You are missing the modifiers LD, LC or RC. They need to know what vessel(s) is being stented.

I was wondering if you code the 93555-26 & 93556-26 with the cath. You can bill those if done just need to add mod 59 bec of the Stent.;)

Hope this helps!
 
59 Modifier w/93555 and 93556

We have been following CCI edits. Do you routinely get pd for these for all other insurance companies? We are new at billing these codes.:)


Thanks
 
Yes, we get paid for these but do check documentation to make sure they are reflected in the report.

When injection procedures are performed during a heart cath they require an appropriate supervision and interpretation (S & I) code which would be 93555-26 & 93556-26. You must add mod 59 to bypass CCI edit.

Now if the doctor just does a stent (92980-92984) you would not use any S & I code. The S & I codes go hand in hand with the Heart Catheterization.

Just little more infor. Lets say your doctors just does a (Coronary artery study) 93508, 93545 the S & I code to be used is 93556-26.

Good Luck :)
 
dpumford said:
Yes, we get paid for these but do check documentation to make sure they are reflected in the report.

When injection procedures are performed during a heart cath they require an appropriate supervision and interpretation (S & I) code which would be 93555-26 & 93556-26. You must add mod 59 to bypass CCI edit.

Now if the doctor just does a stent (92980-92984) you would not use any S & I code. The S & I codes go hand in hand with the Heart Catheterization.

Just little more infor. Lets say your doctors just does a (Coronary artery study) 93508, 93545 the S & I code to be used is 93556-26.

Good Luck :)
Click to expand...


Would you have something in writing that says you can bill the S&I for the cath when done with the stent? We are having issues in our office agreeing on this being able to be done and it would help settle it. Thanks
 
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