Wiki 93458 denials

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kathleenl

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Morning,

I am looking for some insight as to why our 93458-26 are getting denied. They are being done in-patient. No other procedure is being done during the procedure. Some of our follow-up staff say that we need to put a 59 on it, but what would it be separate from? There are EKG's being done during the inpatient stay - could that be what the cath's are hitting up against? The EKG's are done by cardiologist while the cath is done by an interventional cardiologist....does that make a difference?

Any help is appreciated - Thanks!
-Kathleen
 
Your EOB's will actually tell you what the denial is. first I would check your LCD and make sure they are not denying for medical nec.
 
Hi - the 93458 will get a denial if that ekg is still on the claim. you must find out if it is medical necessary to erform another one thru the documentation (look at the results) and determine if the ekg is justified. IF NOT JUSTIFIED YOU MUST REMOVE IT FROM THE CLAIM
hope this is helpful to you
 
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