Wiki Carotid Angiography - modifier on these codes

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rufus

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Please Help! I am billing the new carotid angio codes 36222-36226 and they state unilateral and to use a modifier 50 for bilateral, but CMS doesn't recognize the 50 or 59 modifier on these codes. I have also looked for a LCD and NCD on these codes and can't find one. Can anyone please tell me how to bill these. We do these procedures all the time.
Thanks!!!!:confused:
 
According to Q&A session of a webinar with Dr. Z thru AAPC, he states "We NOW recommend -50 modifier per the CPT book. There has been an issue with payment system by CMS where they would not pay on the -50for MD's, however this is supposed to be fixed April 1, so you would be able to rebill the January-March cases for appropriate reimbursement." Apparently the 1st quarter CCI edits do not allow a modifier for these procedures but the 2nd quarter edits should fix the problem.

I find this whole issue to be very frustrating! I'm trying to determine what is the best way to handle these bilateral procedures and there seems to be a lot of differing opinions about which modifier to use. I personally will be going with Dr. Zs above recommendation. It will mean more work down the road, but I don't really see a way around it.
 
I also code using the new code set 36222 - 36228 and have been advised that I need to refer to LCD L31829 Table IX. Extra-Cardiac Angiography (CPT Codes 75625-75724 and 36120 - 36248) Performed during the same encounter as Cardiac Cathereterization. The issue I am having is that my Neurologist do not perform these codes 36222-36228 with cardiac caths so my claims are hitting an edit for a wrong dx code being billed. My claims not even doing past our system!! Am I right in thinking this LCD does not apply to our procedures? Please help!!!!!:confused:

I am also having the issue with the -50 on this code set.....
 
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