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old cath code question

  1. #1
    Location
    Orange Park Florida
    Posts
    41
    Default old cath code question
    Medical Coding Books
    hello,

    last year when we had a stent along with a cath we had to bill a -59 modifier with the cath and S&I codes. we never put it on the injection code 93545. however, we have some from last yr that United healtcare has denied the 93545 stating it cannot be seperately reportable.has anyone else have this issue? should we put a -59 on this procedure even though according to the CCI edits it doesnt state that we need it. if you can help in anyway that would be greatly appreciated. thanks!
    Amanda Solomon CPC, CCC

  2. #2
    Location
    grand canyon(PHX)
    Posts
    24
    Cool
    i have seen this with united health care as well i would call them and explain to them that it is not bundled and maybe send documuntation that it is distinctly diagnostic and then therapeutic (plus CCI)

    you should be able to get it payed. I am not sure why this happens with united

    hope that helps
    id be interested on others expereinces as well
    Robert A Kiesecker CPC CCC CPC-I

  3. #3
    Location
    Orange Park Florida
    Posts
    41
    Default
    thank you so much.
    Amanda Solomon CPC, CCC

  4. #4
    Default
    Yes, I have the same experience with United Healthcare. They are the ONE insurance company that wants the -59 on the 93545 as well. I put it on (even though I know it isn't needed...)

    Jessica CPC, CCC

  5. #5
    Location
    Orange Park Florida
    Posts
    41
    Default
    Ok thank you.
    Amanda Solomon CPC, CCC

  6. #6
    Default
    I also add the 59 mod to the 93545 for UHC

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