Cardiology Coding Alert

Reader Question:

Append -22 or Use Unlisted-Procedure Code for Percusurge

Question: How should we code Percusurge procedures? We've tried using the unlisted-procedure code, but we are being denied payment because the physician performed the procedure at the same time as a stent placement. 
Florida Subscriber

Answer: First, assess how the physician used the Percusurge system. Some providers use it as a distal protection device. If the physician used the Percusurge as a distal protection device, you need to ask your carrier for appropriate billing guidelines. The two current methods are (1) use the unlisted-procedure code 93799 (Unlisted cardiovascular service or procedure) and (2) report your intervention code (92980, Transcatheter placement of an intracoronary stent[s] ...) with modifier -22 (Unusual procedural services). 
 
You need to submit the claim on paper with a copy of the medical record and a letter explaining what the service entailed, what you feel you should be paid and why. 

 

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