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Thread: 36140,36247,37224,75716,75625 denied

  1. #1

    Question 36140,36247,37224,75716,75625 denied

    93458(26) - PAID
    37225 - PAID
    37224 - DENIED - bundled to 37225 but a modifier is allowed
    36247 - DENIED - bundled to 37225 but a modifier is allowed
    36200(59) - DENIED - bundled to 93458 no modifier allowed
    36140 - DENIED - bundled to 37225 but a modifier is allowed
    75716(26/59) - DENIED - bundled to 37225 but a modifier is allowed
    75625(26) - DENIED - bundled to 93458 but a modifier is allowed

    I received these denials but do not have a report, can anyone determine if any of these are eligible for reimbursement. If truely bundled, how so?

    Thanks!

  2. #2

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    93458(26) - PAID
    37225 - PAID
    37224 - DENIED - bundled to 37225 but a modifier is allowed
    36247 - DENIED - bundled to 37225 but a modifier is allowed
    36200(59) - DENIED - bundled to 93458 no modifier allowed
    36140 - DENIED - bundled to 37225 but a modifier is allowed
    75716(26/59) - DENIED - bundled to 37225 but a modifier is allowed
    75625(26) - DENIED - bundled to 93458 but a modifier is allowed

    I received these denials but do not have a report, can anyone determine if any of these are eligible for reimbursement. If truely bundled, how so?

    Thanks!

    Cannot give the correct codes w/o the report;however cannot bill 36200 & 36140 if a selective injection (36247) was done. Always bill selective over non selective codes. Was 32774 & 32775 performed in the same vessel? If so, 32775 includes angioplasty and atherectomy in the femoral/popliteal vessel.

    Hope this has helped.

    Dolores, CCC - CPC

  3. #3
    Join Date
    Apr 2007
    Location
    Ann Arbor
    Posts
    987

    Default

    Quote Originally Posted by coders_rock! View Post
    93458(26) - PAID
    37225 - PAID
    37224 - DENIED - bundled to 37225 but a modifier is allowed
    36247 - DENIED - bundled to 37225 but a modifier is allowed
    36200(59) - DENIED - bundled to 93458 no modifier allowed
    36140 - DENIED - bundled to 37225 but a modifier is allowed
    75716(26/59) - DENIED - bundled to 37225 but a modifier is allowed
    75625(26) - DENIED - bundled to 93458 but a modifier is allowed

    I received these denials but do not have a report, can anyone determine if any of these are eligible for reimbursement. If truely bundled, how so?

    Thanks!
    Again, with no report, I can't be positive with these codes. But this what info. I can give you.
    37225 - Atherectomy W/ ANGIOPLASTY
    37224 - Angioplasty (bundled into 37225) - no modifier
    36247, 36200, and 36140 - These charges are canceled with the interventional code. Read the second paragraph of page 208 of the CPT book which will explain why.
    75716 and 75625 are billable with modifier -59, if the catheter was placed at the level of the renals and the renal arteries are described. Then the catheter must be pulled down to the iliac bifurcation to be able to bill for the extremity angio using two charges. If the catheter was placed at the renals and all imaging was performed from there, then you have to use 75630. If the catheter was placed at the distal abdominal aorta, then you can onlt bill for the extremity angio.
    HTH,
    Jim Pawloski, CIRCC

  4. #4

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    Thanks Jim, I did read page 208. Everything is clear except for the radiology codes.

  5. #5

    Question Need help on the vascular coding please, going crazy

    I don't have the reports but Medicare denied the below. Can anyone help me determine why?

    36870 59: Denied bundled
    35476 59: Denied bundled
    75978 26 59: Paid
    35475 59: Denied bundled
    75962 26 59: Paid
    75710 26 59: Paid.

    Also can you tell me where I can find the primary procedures to these codes?

    Thank you!!!

  6. #6
    Join Date
    Apr 2007
    Location
    Birmingham, Alabama
    Posts
    886

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    Quote Originally Posted by angelorayhurst@gmail.com View Post
    I don't have the reports but Medicare denied the below. Can anyone help me determine why?

    36870 59: Denied bundled
    35476 59: Denied bundled
    75978 26 59: Paid
    35475 59: Denied bundled
    75962 26 59: Paid
    75710 26 59: Paid.

    Also can you tell me where I can find the primary procedures to these codes?

    Thank you!!!
    The codes that you show as denied are primary procedures. You say they are bundled, what did they bundle with? Are there other codes that were used as well? Was this one case/session? Is it a dialysis graft procedure? If so, did you code 36147?
    Perhaps you can provide the report?

    Danny L. Peoples
    CIRCC,CPC

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