# Stents CPT 92980, 92981



## jaud63 (Oct 19, 2009)

We are receiving a WPS denial on both of these stents being used with the CPT 93510, 93543 and 93545. This is what our charges look like.

93510-26
93543
93545
92980
92981

The denial specifically states (denial code CO4) The procedure code is inconsistent with modifier used or a required modifier is missing.

Has anyone else received this denial? Does anyone know why different modifiers would be necessary? 

Thanks


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## dpumford (Oct 19, 2009)

You are missing the modifiers LD, LC or RC.  They need to know what vessel(s) is being stented.  

I was wondering if you code the 93555-26 & 93556-26 with the cath.  You can bill those if done just need to add mod 59 bec of the Stent.

Hope this helps!


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## jaud63 (Oct 20, 2009)

*59 Modifier w/93555 and 93556*

We have been following CCI edits. Do you routinely get pd for these for all other insurance companies? We are new at billing these codes. 


Thanks


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## dpumford (Oct 20, 2009)

Yes, we get paid for these but do check documentation to make sure they are reflected in the report.

When injection procedures are performed during a heart cath they require an appropriate supervision and interpretation  (S & I) code which would be 93555-26 & 93556-26.  You must add mod 59 to bypass CCI edit.  

Now if the doctor just does a stent (92980-92984) you would not use any S & I code.  The S & I codes go hand in hand with the Heart Catheterization.  

Just little more infor.  Lets say your doctors just does a (Coronary artery study) 93508, 93545 the S & I code to be used is 93556-26.

Good Luck


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## Jaynine122 (Nov 4, 2009)

dpumford said:


> Yes, we get paid for these but do check documentation to make sure they are reflected in the report.
> 
> When injection procedures are performed during a heart cath they require an appropriate supervision and interpretation  (S & I) code which would be 93555-26 & 93556-26.  You must add mod 59 to bypass CCI edit.
> 
> ...




Would you have something in writing that says you can bill the S&I for the cath when done with the stent? We are having issues in our office agreeing on this being able to be done and it would help settle it. Thanks


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## TWinsor (Nov 24, 2009)

The CCI edits also bundlethe 92980 and 92981.  You will need -59 modifier on the S&I codes and the 92981.


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## TWinsor (Nov 24, 2009)

The CCI edits also bundle the 92981with the 92980.  You will need -59 modifier on the S&I codes and the 92981.


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