Cardiology Coding Alert

Question: When I report a comprehensive electrophysiology study and tilt table test on the same day, do I need to append modifier 59? Idaho SubscriberAnswer: You should not need to append modifier 59 (Distinct procedural service) because Correct Coding Initiative (CCI) edits do not bundle 93620-+93622 (Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia ...) with 93660 (Evaluation of cardiovascular function with tilt-table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention).Watch out: Some payers require prior authorization for tilt-table testing or have very specific coverage criteria. For example, Blue Cross of Idaho's medical policy indicates tilttable testing to diagnose syncope is investigational, but the test "may be considered medically necessary for the classification of neurogenic syncope in patients who are being considered for pacemaker treatment" (www.bcidaho.com/providers/medical_policies/med/mp_20109.asp).Many payers will cover 93660 only when [...]