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Thread: Cardiac Catheter Bundling Question

  1. #1
    Join Date
    Apr 2007
    Location
    Springfield, MO
    Posts
    258

    Default Cardiac Catheter Bundling Question

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    Hello,

    Does anyone know why UHC would be denying 93540 with 93510?

    Thanks,
    Amy
    Amy Bishard, BA, CPC, CPMA, CEMC, CCS, RCC
    Instructor, Medical Billing and Coding, Cox College
    amy.bishard@coxcollege.edu
    2015 Education Officer - Springfield MO AAPC Chapter
    Former AAPC Chapter Association Board of Directors 2012-2015
    2011 President - Springfield MO AAPC Chapter
    2010 President Elect - Springfield MO AAPC Chapter

  2. #2

    Default

    What other codes were billed with the heart cath. Was another procedure performed the same day? The reason why I ask is because UHC has denied 93540 but it was billed the same day as a stent placement. We rebilled 93540 with modifier 59 and some claims were paid.

    Dolores, CPC-CCC

  3. #3
    Join Date
    Apr 2007
    Location
    Green Bay
    Posts
    402

    Default

    I agree with Dolores. UHC for me as well will deny if I don't have a -59 modifier on the 93545 and 93540 when there is a stent done in the same session.

    Jessica CPC, CCC

  4. #4
    Join Date
    Apr 2007
    Location
    Springfield, MO
    Posts
    258

    Default

    Yes, a stent (CPT 92980) was also performed. What is their reasoning? I'm not comfortable simply appending a 59 modifier as that could be a red flag.

    Thanks for any help!
    Amy Bishard, BA, CPC, CPMA, CEMC, CCS, RCC
    Instructor, Medical Billing and Coding, Cox College
    amy.bishard@coxcollege.edu
    2015 Education Officer - Springfield MO AAPC Chapter
    Former AAPC Chapter Association Board of Directors 2012-2015
    2011 President - Springfield MO AAPC Chapter
    2010 President Elect - Springfield MO AAPC Chapter

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