Wiki PLEASE CRITIQUE CODES PROVIDED BY DOCTOR FOR CATH LAB PROCEDURE

[mitzimarie2001@yahoo.com]

I am so frustrated... to make a long story short: I work for a billing company. I bill for 2 cardiologists; one of them provides good codes and most of his claims are processed/paid without problems. The other cardiologist does not take suggestions from us, and her claims are often denied. I am providing Cath Lab procedure notes, and the codes that she provided to be billed. I am not a coder, so I don't have a lot of experience. Please critique; I need to know which codes are wrong, and why. Thank you in advance.


The procedure codes she provided are:
93458-26
93567-XU
75710-26, XU
99152
76937-26, XU
36245
36252-XS, 51

Because I usually just bill the codes provided by the doctors, I don't have experience coding from procedure notes. Please talk me off of the ledge....

Mitzi

 

[Jim Pawloski]

Hi Mitzi,
All that I can see from the report is 93458 and 93567. 75710 is part of the closure device, not separately billed. 99152 cannot be coded as an independent trained observer giving sedation is not documented. 76937 is bundled in the cardiac cath. 36245 would be bundled into 36252 (and the heart cath) and 36252 is a selective catheterization and is not documented.
Don't jump! We are here to help you...
HTH,
Jim