Wiki PLEASE HELP!!! Coding help for 93458 & 36245

[aliciaw1]

Blue Cross Blue Shield is denying both CPT 36245-59's. Operative report is attached. I have come up with 93458-26 36245-59 36245-59 75726-26-59 75726-26-59 99152. Please advise on the correct coding. Thanks in advance.

 

[arclayton]

Coding looks correct. What diagnosis code did you use to justify the Celiac and SMA angiograms?

 

[aliciaw1]

Coding looks correct. What diagnosis code did you use to justify the Celiac and SMA angiograms?

I77.4

 

[drsmith1999@gmail.com]

What is the denial reason?

 

[arclayton]

I can't find BCBS LCD, but I77.4 is on CMS's LCD. Having said that the op report states mesenteric ischemia, which would be coded to K55.1. The reason for the denial would be helpful.

 

[aliciaw1]

What is the denial reason?

They are stating it is included in 93458-26.

 

[aliciaw1]

I can't find BCBS LCD, but I77.4 is on CMS's LCD. Having said that the op report states mesenteric ischemia, which would be coded to K55.1. The reason for the denial would be helpful.

They are stating it is included in 93458-26.