Wiki Diagnostic Angiography Coding Question

veagan

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Hi, I have a question for any Neurosurgery coders....We are billing the diagnostic NSY codes CPT 36224 with the RT modifier & diagnostic CPT codes 36223 & 36225 with the LT modifier for the same DOS/same patient. The only ICD 10 is I63.511 for the right middle cerebral artery because that is where the problem was found. Humana Medicare is denying the 36223-LT & 36225-LT as not medically necessary since the only dx we can bill is I63.511 for the Right artery since nothing wrong was found on the Left side. Does anyone know the charges for the left side should be coded? We don't want to add dx I63.512 for the left artery since that would give the patient a problem he doesn't have. Any suggestions? Thanks so much for your help!! Happy Holidays!!
 
I may not be a full expert on the matter but if there was no no problem on the left artery, it is medically necessary to examine for patient health by the specialist but if nothing wrong was found, i believe that the insurance will not pay for it but there is no harm in mentioning it.
 
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