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Codes 93555 & 93556

  1. #1
    Default Codes 93555 & 93556
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    I have always used these codes for the imaging on a heart cath with the modifier of 26. Recently Aetna has told us that we have to bill those codes without the modifier. I am confused as to why we would bill these without the professional component. Wondering if anyone else has had this problem before with any other carrier. I know the modifier is correct but cannot understand why we would ever bill those imaging codes without them.
    Thanks for the help
    Jessica Chandler CPC, COC, CPC-P, CPB, CCC
    Charleston, WV

  2. Default
    Unfortunately, I am as confused as you are, Medicare has been denying 93556 and 93555 saying inappropriate modifyer

  3. #3
    Default
    Quote Originally Posted by jessica1974 View Post
    I have always used these codes for the imaging on a heart cath with the modifier of 26. Recently Aetna has told us that we have to bill those codes without the modifier. I am confused as to why we would bill these without the professional component. Wondering if anyone else has had this problem before with any other carrier. I know the modifier is correct but cannot understand why we would ever bill those imaging codes without them.
    Thanks for the help
    If the same doctor who performed the procedure is interpreting the films, in my opinion, the modifier is not needed. If someone else is performing the S&I, then I would use the modifier.

    HTH,
    Jim Pawloski, CIRCC

  4. Default
    It is not listed in the MPFS Indicators with a 26 modifer.
    Brittany L., CPC

  5. #5
    Location
    Bay City, Michigan
    Posts
    48
    Default
    This is a very old post. 93555 &93556 were deleted several years ago.

    C Collison CPPM, CCC

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