Modifier -59 is appropriate on the 36245 and you may also find it necessary to append the modifier on your S&I code.
Modifier -59 is supported if:
Medical necessity is supported for the selective procedure (this does not include screening).
A complete procedure was performed (meaning everything was done that would have been done if a cath was not performed).
Per Dr. Z's Medical Coding Series Diagnostic & Interventional Cardiovascular Coding Reference:
"When selective catheterization of non-coronary arteries is performed during cardiac catheterization, utilize selective catheter placement codes 36245-36248 and/or 36215-36218 as appropriate per peripheral coding instruction."
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