General Surgery Coding Alert

Question: Recently, some insurance companies have bundled bilateral selective renal arteriography with heart catheterizations. I have received at least three rejections stating that bilateral selective renal arteriography is not usually paid separately. Typically, carriers pay for the heart catheterization and the radiological supervision and interpretation code but not for the bilateral selective renals. Why?

Maryland Subscriber

Answer: Heart catheterizations include introduction and movement of the catheter. Similarly, selective catheterizations also include introduction and movement of the catheter. Therefore, the two procedures are bundled into heart catheterizations (93530-93533). However, you should report this service by adding modifier -59 (Distinct procedural service) to report it as a distinct procedure.