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Billing Medicare for 93571

  1. Talking Billing Medicare for 93571
    Medical Coding Books
    Hi, I am having trouble getting Medicare to pay 93571 (fractional flow reserve)
    92982 LC 22
    93458 26
    99223 25
    93571 LC all w/dx of 414.00 what am I doing wrong? Thanks Nancy

  2. #2
    You need to add 26 modifier to 93571. Hope this helps!
    Susie Corrado, CPC
    ENT Coding/Billing

  3. #3
    i was thinking i read somewhere you couldn't charge for the 93571-26 when you actually do an intervention to the vessel... that it was included in that.. but i'm still looking to see where i saw that... has anyone else saw that??


  4. #4
    Default 93571 & Medicare
    We had originally billed these with a 26 modifier and a LD/LC/RC and were getting denied for invalid/missing modifier. We took the LD/LC/RC off and resubmitted and then received payment.

    My advice would be to bill with a 26 modifier, and leave off the vessel modifier.

    Hope this helps! Good luck!
    A.Dimmitt, CPC, CIRCC
    Durham, North Carolina

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