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Wiki Drug challenge with Isuproterenol

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aschaeve

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Fond Du Lac, WI
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I have a physician that performed a EP Ablation PVC but did it with a drug challenge. The anesthesia was MAC. CPT code 96365 was billed by the surgeon. There is no crosswalk for this code. We tried billing with 01999, but it was denied by Dean ins.

Anyone have a suggestion as how to bill this?

Thanks,

Alicia, CPC
 
Hi there, try submitting the additional information that supports the medical necessity for MAC. Even if it seems obvious - eg the patient's age - you may need to spell it out in the appeal.
 
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