Cardiology Coding Alert
LC, LD, and RC May Have Been Overlooked
Question: Our Medicare contractor won’t accept modifiers LC, LD, and RC with the new PCI codes. Are we missing something?
Answer: Several coders have reported similar denials and have shared that at least one contractor has acknowledged it needs to and will update its system to resolve the issue.
Alert your payer that it needs to review its modifier/code pairings if it’s denying the new percutaneous coronary intervention (PCI) codes when reported with one of the following modifiers:
LC, Left circumflex coronary artery
LD, Left anterior descending coronary artery
RC, Right coronary artery.
Also be sure the payer will accept the new coronary modifiers:
LM, Left main coronary artery
RI, Ramus intermedius coronary artery.
Once your payer resolves the issue, confirm whether they will automatically adjust all claims going back to Jan. 1, 2013, or whether you need to resubmit the claims that were denied in error.
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Cardiology Coding Alert
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