Cardiology Coding Alert

Question: We're having trouble getting 93527 reimbursement. I've heard we should use modifier 26. Is this true? California Subscriber Answer: The Medicare Physician Fee Schedule only prices the professional component of 93527 (Combined right heart catheterization and transseptal left heart catheterization through intact septum [with or without retrograde left heart catheterization]). You should represent this as 93527-26 (Professional component). Crucial: Code 93527 is appropriate when the cardiologist performs a combined (right and left) diagnostic heart catheterization that happens to include a transseptal puncture. If the cardiologist instead performs transseptal punctures to ease complex electrophysiologic procedures, such as atrial fibrillation ablations, you should not use 93527. Try this: Experts advise attaching modifier 22 (Increased procedural services) to the ablation, for example, supraventricular tachycardia (SVT) ablation code (93651-22, Intracardiac catheter ablation of arrhythmogenic focus; for treatment of supraventricular tachycardia by ablation of fast or slow atrioventricular pathways, accessory atrioventricular connections or other [...]