Reader Question: Cardiac Catheters

Question: We are a specialty hospital that on an outpatient basis performs a number of catheter placements, which we have been coding 93508. However, for outpatient Medicare patients, we are not paid for 93508 as a procedure because it is considered an APC status indicator type N for incidental services. We perform 93508 as a primary procedure. The only time we are paid is when another service, such as an EKG and/or a chest x-ray, is performed on the same date of service. Then we are paid under outlier status. We believe our best option is for the N indicator to be changed in the future to S (significant APC procedures that are not subject to multiple procedural discounting). Are other options available?

Texas Subscriber

Answer: Because you are required to use the code that most accurately identifies the service, Medicare might consider it fraudulent to use less descriptive codes to compensate you for the resources associated with performing the 93508 (catheter placement in coronary artery[s], arterial coronary conduit[s] and/or venous coronary bypass graft[s] for coronary angiography without concomitant left heart catheterization). To request a change in the status indicator associated with the service, you might contact your fiscal intermediary and HCFA to request consideration for revision of the procedures status. And, ask your carrier for their interpretation of the best way to bill this service.


- Published on 2001-06-01