Cardiology Coding Alert

Grasping PCTC indicator concepts sets you up for cleaner 93508 claims. In "Case Study: Crack Down on a Top Heart Cath Coding Snafu," correct coding required appending modifier 26 to 93508 and 93556 because the procedures took place in a facility. But modifier 26 was conspicuously absent from 93545, which the cardiologist performed at the same session. The physician fee schedule's PCTC column holds the key. Reason: If you look up 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) and 93556 (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]) in the Medicare physician fee schedule (for example, www.cms.hhs.gov/PFSlookup/), you'll find that the fee schedule shows a "1" in the PCTC column for 93508 [...]