# 93556 (x2)?



## armymomryan (Aug 10, 2010)

I was under the impression that you could not bill 93556 (S&I code) more than once per cath procedure but a friend is billing (and ask my thougths) it 
X2 if the doc states COR and RFA - any thoughts?  Apparently Medicare and BCBS have paid it this way for her.


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## Jim Pawloski (Aug 11, 2010)

armymomryan said:


> I was under the impression that you could not bill 93556 (S&I code) more than once per cath procedure but a friend is billing (and ask my thougths) it
> X2 if the doc states COR and RFA - any thoughts?  Apparently Medicare and BCBS have paid it this way for her.



93556 can only be billed once, and as for RFA, if I can assume that it is for a closure device, it is bundled in the closure divice code.
HTH,
Jim Pawloski, CIRCC


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## armymomryan (Aug 11, 2010)

yes, very confusing Jim, documentation states coronary angiography AND right femoral artery angiogram, (along with left ventriculography and left heart cath)

I told her to code as follows (her Dr is prof comp only)

93510-26 (LHC)
93545 (COR Injection)
93543 (LVG Injection)
93556-26 (COR Imaging)
93555-26 (LVG Imaging)

but she says they are paying if she puts X2 on 93556 for imaging the Right femoral artery as well as the coronary angiography, so the question is, if not X2, what code is for the right femoral artery angiogram (??)


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## Jess1125 (Aug 11, 2010)

The code for the right femoral arteriogram would be 75710-26 IF it is a diagnostic study.

The femoral angiogram being done just simply to see if a closure device can be placed is NOT separately billable. 

Pasted below is an excerpt from the NCCI manual:

17. Placement of an occlusive device such as an angio seal or vascular plug into an arterial or venous access site after cardiac catheterization or other diagnostic or interventional procedure should be reported with HCPCS code G0269. A physician should not separately report an associated imaging code such as CPT code 75710 or HCPCS code G0278.

Jessica CPC, CCC


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## sbicknell (Aug 11, 2010)

I see nothing in the code description that mentions peripheral vacular imagining.......

_Imaging supervision, interpretation and report for injection procedure(s) during cardiac catheterization; pulmonary angiography, aortography, and/or selective coronary angiography including venous bypass grafts and arterial conduits (whether native or used in bypass) _

And I agree with Jim. If the RFA is viewed simply to verify closure/puncture then it is not coded. If the RFA is being viewed as a diagnostic following the heart cath, then perif. vascular has it's own imaging codes

If payment is being made on 93556 x2 then either the payer does not have an edit for the x2, payer doesnt realize she is billing the x2 for the SFA or she is mistaken that she is being paid double. 

In 10+ years of coding/auditing cardiology I have never heard of coding x2 or it being paid


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## armymomryan (Aug 13, 2010)

appreciat your help, that makes it clearer


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## beccy (Sep 22, 2010)

*right and left heart cath w/imaging service-75710-26*

I am getting a bundled edit for this code set as follows: 93526,93545,93543,93555,93556 and lastly 75710-26. 75710 bundles with 93526-in going through the proceudre note i see that he did do a diagnostic right coronary angiography-since the 93546 and the 93555 are to go together as well as the 93545 w/93556; is he reporting this for the right coronary angiography or it is truly bundled into the 93526="combined right heart cath and retrograde left heart cath?

thanks! Karyn cardenas, cpc


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## bkiesecker (Sep 24, 2010)

also if its medicare and the documentation supports it there is a g code that should be billed instead of 75710 or 75716
G0278 if it is a true non selective angiogram of the illics and or femoral


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