Wiki 93571 - fractional flow codes

[csorensen21@yahoo.com]

I am having a huge issue getting any fractional flow codes paid by any carrier especially Medicare. I really need any help or advice on how to bill these correctly. At first I was using vessel modifiers as out patient and still not paid. Attempted use of mod 26. No pay. I also changed to IP status still not paid.


Can someone please help me with this????

I'm beginning to get frustrated. I hear we can get these paid, yet no one can tell me how and I am losing money on these if so.

Thanks!

 

[jenski37]

Modifier 26 would be correct if your Dr is dooing the Professional comp of the proc but you will also need to have the location or vessel modifier also (LC RC LD etc).

Jennifer Domzalski, CPC

 

[csorensen21@yahoo.com]

I have used combo of 26 plus the vessel modifier in an IP and OP status and still not getting paid. Medicare is bundling this code saying it is apart of the catherization or the intervention.

Please someone help me!!

 

[j.monday7814]

I used to bill these with the anatomical modifiers but Medicare always denied them so we stopped using them and have been getting paid without an issue. We always use modifier 26, there is no technical component for this code. POS shouldn't matter, it is billable in O/P and I/P setting. If you still can't get it paid then there must be another issue.

 

[Chlrtrep]

I used to bill these with the anatomical modifiers but Medicare always denied them so we stopped using them and have been getting paid without an issue.

^ we also stopped using anatomical modifier