Cardiology Coding Alert

Reader Questions:

Avoid Multiplying Bilateral 36245 Claims

Question: One of the coders in our office is reporting two units of 36245-50 for bilateral services. I always thought you should use a single unit with modifier 50. Which method is correct? Utah Subscriber Answer: Reporting two units of a code and appending modifier 50 (Bilateral procedure) will equal reporting four services, which is incorrect. The correct method of coding bilateral 36245 (Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family) services will depend on your payer's preference. Some payers prefer that you report your procedure code only once, one unit, with modifier 50 appended (36245-50). Other payers want the code reported using two line items, one unit each, with modifier LT (Left side) attached to one and modifier RT (Right side) attached to the other (36245-LT, 36245-RT), or payers may have another preference. Fee facts: The Medicare Physician [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more