1. Jean Palumbo
   Posted 4 months ago #
   

   Patient underwent diagnostic cardiac cath, 93458, on day one. On day two, patient taken back to Cardiac Cath Lab for IVUS of LAD and RCA. No intervention or diagnostic angio performed. Is this billable with 92978-LD, 92979-RC, what code is used to get guiding cather, marker wire into the vessels?

2. SuperCoder
   Posted 4 months ago #
   

   Intravascular ultrasound may be used during diagnostic evaluation of a coronary vessel or graft. It may also be used both before and after a therapeutic intervention upon a coronary vessel or graft to assess patency and integrity of the vessel or graft. So, for example, to assess patency and integrity of the vessel or graft, the doc can perform on the next day. The question is billing guidelines.
   Now, 92978 & 92979 can't be billed standalone, but need to be billed with 93458. Now, the RVUs of 93458 has far higher than 92978 & 92979, so these should all be billed on first day itself.

3. AnnMarie Piscopo
   Posted 4 months ago #
   

   Along the same lines here in regard to billing for IVUS- when billing for the IVUS interp 75945 should there be a 26/59 modifier appended or is it not necessary? We have been getting denied by some ins co's stating proc is experimental in nature ( we have billed with & without the modifiers in this instance) but will pay the IVUS! Doesnt make sense to me!

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