# 93539



## jtuominen (May 14, 2010)

Now this seems simple but my MD got me all shaken....

Patient presents for LHC with Coronary Angio along with SVG and LIMA gram. Everything is successful except he can't selectively engage the LIMA graft because the patient has an occluded L subclavian. He still charges a LIMA gram but writes in the report that he could not assess it due to the subclavian occlusion. 

Should I....
charge for a LIMA gram with a modifier 74 (im on the facility side)

charge for LIMA gram without any additional modifier. (thinking about the verbiage in that code that says "selective opacification" what the heck are they trying to say?? If they meant selective why didn't they just say selective?)

charge for a unilateral extremity 75710..

Any thoughts to help me snap out of this would be great!


----------



## deeva456 (May 14, 2010)

I would charge 93539-74 as it was done with the heart cath and I assume pt is S/P CABG?  

Dolores CPC-CCC


----------



## twizzle (May 15, 2010)

I probably wouldn't bill the 93539 at all as he didn't selectively engage the LIMA and shoot contrast. If he managed to engage the vessel at all he could have it, otherwise you could consider 93539-52 with documentation showing he tried several times to engage the vessel but without success.


----------

