Ask Dr. Z

Our provider contacted the SCAI, The Society for Cardiovascular Angiography and Interventions, to dispute our recommendation that CPT 76937 is NOT billable with any cardiac (congenital or non-congenital) cath or ep procedures per ZHealth recommendations. The SCAI stated, "There is nothing preventing billing congenital cath w/ 76937 and the RUC database description of work does not address any issue with using this code for vascular access during a cardiac cath. All of the CPT guidelines clearly state the catheterization codes ARE NOT excluded. The congenital cardiac cath codes 93530-93533 DO NOT include imaging guidance for vascular access in the DOW(?) and are therefore allowed." With this information and explaining the NCCI Policy Manual instructions, how do I further justify, not billing CPT 76937 with cath/ep procedures if the provider documents properly?