Cardiology Coding Alert

Question: When a physician performs a left heart cath (93510) in a hospital setting, does he or she bill with a modifier -26?

Paulette Puckett
Kalamazoo, Mich.

Answer: You do need to append a -26 modifier (professional component) to your cath code (93510, 93526, etc.) and also for any imaging that has been done (99355, 93556), says Felecia Bernstein, CPC, an independent coding and reimbursement specialist in Monmouth, N.J. Injection codes (i.e., 93545) do not require the modifier -26. The basic rule of thumb, Bernstein says, is that if you do not own the equipment used during the procedure, you should use a -26 modifier.