Wiki Billing 93452 and 93454 vs 93458 for LHC + LVG + CORS

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Kellyj0h

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Is it incorrect to bill the 93452 along with 93454 for the LHC + LVG + CORS instead of billing 93458 alone for these procedures? What is the difference in billing the two codes for it vs billing only the one code? Am I reading something incorrectly in the descriptions? Any help will be greatly appreciated!
 
Yes, but 93452 is for the LHC +/- LVG, and 93454 is for the Coronary Angiograms. I have not found anything that says you can't bill these two codes instead
of 93458 (LHC +/- LVG + CORS).
 
Kellyj0h said:
Yes, but 93452 is for the LHC +/- LVG, and 93454 is for the Coronary Angiograms. I have not found anything that says you can't bill these two codes instead
of 93458 (LHC +/- LVG + CORS).
Click to expand...

Take a closer look at the code descriptions. Code 93458 actually includes all the verbiage that's in code 93454 PLUS the "with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed".

Jessica CPC, CCC
 
This information can be found in the NCCI Manual, in the introduction at:

https://www.cms.gov/NationalCorrectCodInitEd/01_overview.asp#TopOfPage

It specifically says, "A physician should not report multiple HCPCS/CPT codes when a single comprehensive HCPCS/CPT code desribes these services." and "A physician should not fragment a procedure into component parts," and gives some good examples.

Unbundling, which is what you are describing by breaking the 93458 into it's component parts, is also often listed as examples when false claims are being described.
 
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