Wiki 37228 as prmry code to 93571

[coders_rock!]

Can someone please help me? Mr doc reported:

37228 - paid
93571-26/LD
93572-26/RC - paid
37232 - paid

The insurance carri is denying 93571 for not reporting the primary procedure. I thought 93571 can bill with 37228. Why did they pay 93572 then?

I need help understanding.

Thank you!

 

[donnajrichmond]

Can someone please help me? Mr doc reported:

37228 - paid
93571-26/LD
93572-26/RC - paid
37232 - paid

The insurance carri is denying 93571 for not reporting the primary procedure. I thought 93571 can bill with 37228. Why did they pay 93572 then?

I need help understanding.

Thank you!

93571 and 93572 specify as part of the code description that they are "during coronary angiography". You didn't do coronary angiography (or at least you didn't code it), so those codes should not be coded and the insurance was correct to not pay. If they paid 93572 that's an error, it needs to be sent back.

 

[coders_rock!]

I thought I read somewhere that 93571 is an add-on code that can be billed with coronary angiographies, cardiac catheterizations, or therapeutic interventions. Meaning, you can bill 37228 as the primary.

 

[donnajrichmond]

I thought I read somewhere that 93571 is an add-on code that can be billed with coronary angiographies, cardiac catheterizations, or therapeutic interventions. Meaning, you can bill 37228 as the primary.

it can be billed with coronary angiographies, cardiac catheterizations, or coronary therapeutic interventions. Not peripheral interventions.

 

[coders_rock!]

Thanks Donna, that does make alot of sense.