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

This question was answered in our Peripheral & Cardiology Coder. For more hot topics relating to cardiology services, please visit our store or call us at 1.800.252.1578, ext. 2.

Facebook
Twitter
LinkedIn
Email
Print

CPT® copyright 2021 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.