# Denial issue for 0075t



## TBAUSLEY (Aug 11, 2011)

Hello All,
The physician peformed a LT Vertebral artery stent..we billed 0075T. The claim was denied for modifier needed. The carrier  (Medicare) is requesting/suggesting  that we add a 26 modifier to the CPT code per our f/u dept. 

 This is the first time that we heard that a 26 modifier should be placed on this code?

Has anyone  experienced this scenario from Medicare and/or other carrier? (Michigan)

Thank you in advance.

Tawana


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## dpeoples (Aug 11, 2011)

TBAUSLEY said:


> Hello All,
> The physician peformed a LT Vertebral artery stent..we billed 0075T. The claim was denied for modifier needed. The carrier  (Medicare) is requesting/suggesting  that we add a 26 modifier to the CPT code per our f/u dept.
> 
> This is the first time that we heard that a 26 modifier should be placed on this code?
> ...



Sorry, this is news to me. This code should not require the 26 modifier, please let us know if that works.


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## donnajrichmond (Aug 22, 2011)

TBAUSLEY said:


> Hello All,
> The physician peformed a LT Vertebral artery stent..we billed 0075T. The claim was denied for modifier needed. The carrier  (Medicare) is requesting/suggesting  that we add a 26 modifier to the CPT code per our f/u dept.
> 
> This is the first time that we heard that a 26 modifier should be placed on this code?
> ...



Yes, this code breaks down into PC and TC.  So, if your physician performed the stent placement in the hospital you need to add the -26 modifier.  See the Physician Fee Schedule RVU file, or payment files.


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## glennia.keplar@osumc.edu (Oct 10, 2012)

*ICD-9 code for 0075T*

I was wondering if anyone else was having trouble with a diagnosis code for the 0075T.
It seem like all the insurance conpanies are allowing are the 433.10, 433.11 & 433.30.


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