Kerry Posted Fri 14th of June, 2019 14:40:25 PM
Is there a rule that you can’t bill a IVUS (92978) or a FFR ( 93571) for the branches during a heart catheterization? For instance I have a doctor that performed a 93458 for the left heart cath with coronary arteries. He then performed an IVUS of the OM2, and decided to stent the lesion doing a 92928. I was told per Medlearn Publishing that we can only bill the 92978’s and 93571’s only when they are performed in the main vessels, not the branches. Is this correct?
SuperCoder Answered Mon 17th of June, 2019 11:13:37 AM
Thanks for your query. Our team is working on this and will get back to you soon.
SuperCoder Answered Tue 18th of June, 2019 08:37:09 AM
Thanks for your patience.
IVUS is imaging technique that includes ultrasound transducer and a rotational mirror that is mounted on a catheter tip, which is then inserted directly into the blood vessel. Images of the vessel's internal structure during cardiac catheterization etc. are then produced.
As per the code decriptors of 92978 and 93571 it suggests that these add codes can be used for initial vessel.
There are no NCCI edits (bundling issues) with the left heart catheterization (93458) and stenting codes (92928) with 92978 and 93571.
You can also refer to below mentioned article for your reference similar to this scenario:
If in case, you are not able to acess the article kindly let us know.
Hope this helps.