Wiki Help-New cath codes mod 26 - I code the professional component

[karenk123]

Hi,
I code the professional component for cath lab procedures. We are getting denials from insurance companies across the board. They are stating that modifier 26 is inappropriate for these codes i.e. 93458-26, 93459-26. Does anyone have any insight on this?

Thanks

 

[pdrgos]

-26 mod works for me?? Maybe they are stalling sending $$? I'd give them a call.:/

 

[dphillips]

Modifier -26 is correct. And I have had some payors deny saying that the modifier is inappropriate. Just call them and tell them according to Medicare guidelines, you are billing this correctly. They send it back to be paid then.

Dawn CPC, CCC