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