I know that starting the 2nd quarter of 2011 that I now need a 59 modifier on the heart cath code when I bill a coronary stent also. BUT....all of a sudden the UHC based Medicare replacement policies (Secure Horizons, AARP Medicare Complete, Evercare) are denying the cath codes when I bill them with stents for some reason.
For example, I bill 92980 and 93458-26,51,59 (like I do for every other carrier) and they deny for "unbundled" procedure. So at first I removed the 59 thinking that they don't want that, but then they denied it again for the same reason. So now I removed the 51 and put the 59 back and am waiting to see what happens now.
Anyone else having this problem the last few months with just these few Medicare replacement plans? Seems like something changed when the April 2011 CCI edits started requiring a 59.![Confused :confused: :confused:](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
For example, I bill 92980 and 93458-26,51,59 (like I do for every other carrier) and they deny for "unbundled" procedure. So at first I removed the 59 thinking that they don't want that, but then they denied it again for the same reason. So now I removed the 51 and put the 59 back and am waiting to see what happens now.
Anyone else having this problem the last few months with just these few Medicare replacement plans? Seems like something changed when the April 2011 CCI edits started requiring a 59.