Wiki CPT 76937 with RHC/LHC 93460 ????

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Chlrtrep

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Werecently performed a RHC and LHC on a patient that the physician had difficulty gaining access. therefore he used US Guidance for Vascular Access for the Vein and the Artery. All criteria was meet to code 76937. I was contacted by our RMD department stated the there 3M software program was not allowing 76937 to be charged with this procedure. They were getting a edit code:

Edit 37144-3M: Add-on procedure reported without base code.

I tried to explained that 93460 is the based code however they are saying they need to remove the 76937 code in order to bill.


Has anyone experienced this before or have any idea what base codes are allowed for cpt 76937.. I was under the impression that those cases that specially include US in the code like thelist in the CPT manual were the only ones you were not allow to code76937 with
 
Chlrtrep said:
Werecently performed a RHC and LHC on a patient that the physician had difficulty gaining access. therefore he used US Guidance for Vascular Access for the Vein and the Artery. All criteria was meet to code 76937. I was contacted by our RMD department stated the there 3M software program was not allowing 76937 to be charged with this procedure. They were getting a edit code:

Edit 37144-3M: Add-on procedure reported without base code.

I tried to explained that 93460 is the based code however they are saying they need to remove the 76937 code in order to bill.


Has anyone experienced this before or have any idea what base codes are allowed for cpt 76937.. I was under the impression that those cases that specially include US in the code like thelist in the CPT manual were the only ones you were not allow to code76937 with
Click to expand...

Try using modifer -59 with this. I think it should go thru.
HTH,
Jim Pawloski, CIRCC
 
No that is not an option.. I code for al the IT Cath and EP procedures I have given references regarding the use of 76937 and the documentation required. However, the RVM dept. will not allow this to go through. They feel it is an inappropriate use of the code and would like to apply CPT code 76942. I am at a loss here. Their argument is that it is causing a CMS edit and there software will not allow it to be coded together. They are using the reference " You have coded76937 which is an add-on code and must be reported in conjunction with a surgical and imaging procedure ( e.g, venous catheterization, VAD or other vascular access procedures: reference AMA CPT Book"

I responded: This is a venous access procedure and an arterial access procedure. which is listed the reference you have supplied.
 
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