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New Vascular Codes

  1. #1
    Location
    Jacksonville NC
    Posts
    14
    Question New Vascular Codes
    Medical Coding Books
    I am coding in a physician office setting. Should I be appending a the -26 modifier to the new codes 37220-37235. Any help would be appreciated.

    Thanks,
    Tracy

  2. #2
    Default
    Quote Originally Posted by tbanks75 View Post
    I am coding in a physician office setting. Should I be appending a the -26 modifier to the new codes 37220-37235. Any help would be appreciated.

    Thanks,
    Tracy
    Don't append the -26 modifier.

    Jessica CPC, CCC

  3. Default
    what about the new cath codes when billing for the physician? Does anyone have any official documentation on whether or not to append mod 26?

  4. #4
    Location
    Phoenix, AZ
    Posts
    620
    Default
    If the cath is done in a hospital setting, then you would append the -26.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  5. #5
    Default Modifier -26 for Cardiology and Peripheral
    On the Cardiac Cath codes 93451-93461, yes the modifier -26 is necessary, if you do not own your own cath lab or facility where the procedure is performed. You are providing the "professional component" of the diagnostic service.

    On the new Peripheral Vascular codes, these are considered procedures, and not a diagnostic, 2 component service. So you would code them out, without the -26 modifier.

    If you are ever in doubt, the easiest way to know, is to go to your Medicare fee schedule, and if the codes are listed 3 times, once with a -26 (professional), once with a -TC (technical), and once with no modifier (global), and you are not the owner of the facility/IDTF/Cath lab where performed, then a -26 is appropriate.

    Hope that helps.
    Terry
    Terry A. Fletcher BS, CPC, CCC, CEMC, CMSCS, CMC, CCS-P, CCS
    Healthcare Coding Consultant

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