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93458 bundled with 36245

  1. #1
    Question 93458 bundled with 36245
    Medical Coding Books
    If a physician performs a cardiac cath 93458 and a Selective Lower Extremity Angiogram 36245 at the same time, is it appropriate to append a modifier -59 to bypass the bundling rule? If so, what makes it OK to add modifier -59?

    Thanks in advance.

  2. #2
    Kansas City, MO
    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."
    Olivia Price, CPC, CCC
    Physician Coder Supervisor
    The University of Kansas Health System

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