Wiki Which modifier would I use?

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jdibble

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Which modifier would you use and on which code for the following scenario:

Patient had an abdominal aortagram and bilateral fermoral angiogram with run-off and then selective catheter placement in the the left popliteal artery. This was followed by placement of an EKOS catheter with TPA treatment for 8 hours on the same date of service. I used codes 36247, 37211, 75625-26-59, 75716-26-59.

After the 8 hours, on the same date of service, the patient was brought back to the operating room for a post-thrombolytic left femoral angiogram, removal of the EKOS and stenting of the distal left superficial femoral artery. I am using code 37226.

If these are the correct codes, CCI edits say that code 36247 is bundled into 37226 and I need a modifier applied to bill both (modifier should be applied to 36247 - the first procedure). Should I code it that way with a 59 modifier on the 36247 even thought the other procedure was second. Or would I use modifier 58? And if so, which code would I apply that to?

Any suggestions?

Thanks,
 
37226 is lower extremity intervention code which include the selective catheterization cpt codes (36245-36247), hence we cannot code this together, so only 37226 should be reported..:)
 
if the access of both procedure is different you can code 36247 with 59 modifier along with 37226......if same access we have to use 37226 only:)
 
37226 is lower extremity intervention code which include the selective catheterization cpt codes (36245-36247), hence we cannot code this together, so only 37226 should be reported..
Click to expand...

if the access of both procedure is different you can code 36247 with 59 modifier along with 37226......if same access we have to use 37226 only
Click to expand...

These were 2 separate sessions - on the same date of service, but 8 hours apart. The physician performed Thrombolysis using TPA with an EKOS catheter for 8 hours. He then returned the patient to the procedure room for a post-thrombolytic angiogram - 8 hours later, at which time he made the decision to perform the stenting. So the question is - is this a separate distinct procedure, modifier 59 or a staged procedure, 58 modifier?

Thanks!
 
need to check the whole report, depends if the patient had any complication after first session or this was a planned visit by the patient...please post the whole report:confused:
 
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