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Highmark denial for 93458

  1. Default Highmark denial for 93458
    Medical Coding Books
    Our office has billed the 92980.LD, 92978.26 and the 93458.26. Highmark paid the 92980 and the 92978 but denied the 93458 as not covered by same session or date. I looked at CMS website and cannot find any CCI edits for 93458. Can i just add 59 modifier to the 93458.26? Any suggestions on how I can get this paid?

    Thank you

    Tonya CPC

  2. #2
    Default
    If you do a stent then the cath code needs to have the 26 and 59 modifier. Hope this helps!
    Susie Corrado, CPC
    __________________
    ENT Coding/Billing

  3. #3
    Location
    Alexandria, LA
    Posts
    518
    Default
    Quote Originally Posted by mcgraws View Post
    Our office has billed the 92980.LD, 92978.26 and the 93458.26. Highmark paid the 92980 and the 92978 but denied the 93458 as not covered by same session or date. I looked at CMS website and cannot find any CCI edits for 93458. Can i just add 59 modifier to the 93458.26? Any suggestions on how I can get this paid?

    Thank you

    Tonya CPC
    In CCI 93458 is a Column 2 code to 92980. If this was a separate diagnostic heart cath then add modifier 59.

  4. Default
    Thank you all for your help

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