Results 1 to 4 of 4

catheter bundling issue with 75716-26

  1. Default catheter bundling issue with 75716-26
    Medical Coding Books
    Has anyone else been experiencing a bundling denial of the catheter,in my 2 cases 36247, with 75716-26. I had a denial from our Medicaid carrier and after 3 appeals finally removed the 75716-26 ( paid about $60) and was paid for the catheterization 36247( over $1000) however still do not feel this is correct and I am now experiencing the same issue with Aetna. There are no other procedures billed in either case only the catheter 36247 with 75625-26 and 75716-26. Both Medicaid and Aetna have denied the catheter stating it is incidental to 75716-26.

  2. #2
    Alexandria, LA
    Sounds like when they put the new revascularization codes in, they set up their edits in a way that bundles catheterization with angiogram whether or not the revascularization was provided. Someone needs to contact them and ask them to explain the edits.

  3. Default
    Thank-you, I agree. We argued until we were blue in the face with our Medicaid contractor to no avail however we will try with Aetna and may have to take this to our provider rep. I will however be checking these edits very closely since losing the catheter payment is very costly.

  4. #4
    Melbourne, FL
    Default aetna
    It is Aetna's scrub/payment software-they definitely have the new revascularization codes combined with all of the angios. Requires a 59 now for all angios even without 37220-37233.

Similar Threads

  1. bundling issue
    By efuhrmann in forum ENT/Otolaryngology
    Replies: 7
    Last Post: 01-06-2015, 08:38 AM
  2. Bundling issue!!!
    By Orthocoder269 in forum Orthopaedics
    Replies: 2
    Last Post: 03-15-2014, 04:28 AM
  3. Bundling Issue
    By nyyankees in forum Gastroenterology
    Replies: 2
    Last Post: 08-31-2011, 01:00 PM
  4. bundling issue help
    By paula f3 in forum Outpatient Facilities
    Replies: 0
    Last Post: 05-06-2010, 01:16 PM
  5. PT bundling issue
    By orthopaedic01 in forum Orthopaedics
    Replies: 1
    Last Post: 02-08-2010, 03:26 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.