Hello, I am having trouble with denials with CPT 36215.
I currently have a few denials stating 36215 is bundled with 36223. From what I understand, there are three vascular families that come off the Aorta. We have the innominate, left common carotid, and Left Subclavian. Provider performed a left coronary angiogram, bilateral carotid and cerebral angiogram and left subclavian angiography. We billed as 93459 mod 26, 36223 mod 50,59 and 36215 mod LT,59. Claim originally denied cpt 36215 as invalid modifier, we corrected claim and removed modifier LT from 36215, and now cpt 36215 denied stating its a bundled procedure. My next step is to appeal the claim; however, I want to make sure I am understanding the vascular family correct. The left subclavian artery is separate from the innominate, and left carotid, therefor it is separately billable, is this correct? I believe the right subclavian is included in the innominate artery, and that would be bundled.
Thank you,
Rosio Hernandez
I currently have a few denials stating 36215 is bundled with 36223. From what I understand, there are three vascular families that come off the Aorta. We have the innominate, left common carotid, and Left Subclavian. Provider performed a left coronary angiogram, bilateral carotid and cerebral angiogram and left subclavian angiography. We billed as 93459 mod 26, 36223 mod 50,59 and 36215 mod LT,59. Claim originally denied cpt 36215 as invalid modifier, we corrected claim and removed modifier LT from 36215, and now cpt 36215 denied stating its a bundled procedure. My next step is to appeal the claim; however, I want to make sure I am understanding the vascular family correct. The left subclavian artery is separate from the innominate, and left carotid, therefor it is separately billable, is this correct? I believe the right subclavian is included in the innominate artery, and that would be bundled.
Thank you,
Rosio Hernandez