Cardiology Question for the Week of September 19, 2022

Question:

What modifier is needed when completing diagnostic cardiac catheterization when performed in conjunction with a coronary intervention?

Answer:

If meeting the criteria listed below when billing, it will most likely require that modifier 59 (or an X modifier subset of modifier 59, such as XU modifier for Medicare plans) be assigned to diagnostic cardiac catheterization or coronary angiography when performed in conjunction with a coronary intervention.

• No previous study is available
• A full and complete diagnostic study is performed
• Physician documents that the patient’s signs and symptoms had changed since the prior study necessitating a new study
• Physician documents that the patient’s signs and symptoms changed during an interventional procedure
• Physician documents that the previous study was not satisfactory
• Diagnostic cardiac catheterization or coronary angiography is performed during a different encounter

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