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Billing 93452 and 93454 vs 93458 for LHC + LVG + CORS

  1. #1
    Question Billing 93452 and 93454 vs 93458 for LHC + LVG + CORS
    Medical Coding Books
    Is it incorrect to bill the 93452 along with 93454 for the LHC + LVG + CORS instead of billing 93458 alone for these procedures? What is the difference in billing the two codes for it vs billing only the one code? Am I reading something incorrectly in the descriptions? Any help will be greatly appreciated!

  2. #2
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    Yes it is incorrect. The description for 93458 is coronary artery(s) with LHC and LVG when performed. Its just the one code.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  3. #3
    Question
    Yes, but 93452 is for the LHC +/- LVG, and 93454 is for the Coronary Angiograms. I have not found anything that says you can't bill these two codes instead
    of 93458 (LHC +/- LVG + CORS).

  4. #4
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    Quote Originally Posted by Kellyj0h View Post
    Yes, but 93452 is for the LHC +/- LVG, and 93454 is for the Coronary Angiograms. I have not found anything that says you can't bill these two codes instead
    of 93458 (LHC +/- LVG + CORS).
    Take a closer look at the code descriptions. Code 93458 actually includes all the verbiage that's in code 93454 PLUS the "with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed".

    Jessica CPC, CCC

  5. #5
    Default
    This information can be found in the NCCI Manual, in the introduction at:

    https://www.cms.gov/NationalCorrectC....asp#TopOfPage

    It specifically says, "A physician should not report multiple HCPCS/CPT codes when a single comprehensive HCPCS/CPT code desribes these services." and "A physician should not fragment a procedure into component parts," and gives some good examples.

    Unbundling, which is what you are describing by breaking the 93458 into it's component parts, is also often listed as examples when false claims are being described.

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