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Heart cath and Renal Selective

  1. Default Heart cath and Renal Selective
    Medical Coding Books
    I am unsure of the modifiers I am supposed to be using.

    I am just going to give and example of a heart cath and renal selective procedure done, I am new to cardio coding so very interesting!!

    Lets say the doctor did:

    R&L heart cath
    Inj proc LVG
    Inj Proc AOG
    Inj Proc COR
    S&I LVG
    S&I COR
    Coronary Stent in Left decending
    IVUS coronary single
    DIAG Cath Placement Renal
    Renal selective:bilateral

    Would the coding be this?

    93556-26-59 would I use the modifier 59 because there was a stent placement? If there was not a stent placement I would not use the modifier 59 is that correct?
    92978 not sure if this needs a modifier or not?
    36245-59 not sure on this I believe I need a modifier 59 because it was done with the heart cath and stent placement but not sure!!
    75724-26-59 would I use the 59 on this?

    One more example:

    On this one there was not a heart cath at all just stent placement

    INJ Proc Cor
    S&I cor
    Coronary stent to right coronary
    cath placement renal
    renal selective unilateral

    So my codes for this is:

    36245 would I use the modifier 59 since there was stent placement?

    I look at this so much I make myself confussed. Thank you for helping in my time of losing my mind in the world of Cardio

  2. Smile
    You are fairly close to using the correct codes, dont need some of the modifiers.
    92980 - no modifier
    93543-51 (some payers may require modifier 51)


    #2 Coronary stent

    Code only 92980. 93545 & 93556-26 cath placement and imagind is bundled with 92980 and cannot code separately unless the heart cath was done first and the doctor discovered the occlusion, lesion etc and decided to do the stent. otherwise bill as follows:

    92980 - no modifier
    75722-2659 ( is this a unilateral study?)

    Only use modifiers on 92980 if stents are placed in more than 1 coronary artery; RC, LD or LC. example 92980-RC 92981-LC.

    I hope this helps to lessen your confusion.

    Dolores, CPC,CCC

  3. Default
    Thank You Dolores

    Would I use a 59 modifier on 36245 and 75722 or 75724 if there was no intervention placements and just a hearth cath done?

  4. Default

    Yes, you would use modifier 59 on 36245, 75722 & 75724 if billed with
    only a heart cath and it is a renal selective catheter placement.

    Dolores, CPC,CCC

  5. Default Code 93526-26
    I'm new to cardio coding.. just want to know why the need for mod 26 with this code (93526)?

  6. #6
    The 93526 would be reported with a -26 modifier because the above case is taking place in a facility that will report the technical component and we would only be reporting for the professional component.

    Jessica CPC, CCC

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