Error in Carotid Angiography Codes

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It has come to the attention of the SVS Health Policy Committee that there appears to be an error in the 2013 Medicare Physician Fee Schedule for the new carotid angiography codes. (Codes 36222-36226).

The 2013 Medicare Physician Fee Schedule essentially prohibits the use of Modifier -50 when bilateral procedures are performed on CPT codes 36222-36226 because there is an indicator “0” attached to each. Payment is 100 percent for a unilateral procedure. It also means that when the -50 modifier is appended as per the CPT manual introductory guidelines for a bilateral procedure, payment is still only 100 percent and not 150 percent as would be the case if there was an indicator of “1”.

Medicare will fix the carotid issue will be fixed by April 1, 2013, retroactive to January 1, 2013.

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