Wiki Cardioversion & Discharge

[dpumford]

Hi!
Hope someone can help clarify this:

If a doctor does a cardioversion and then does a discharges on the same day, do you feel a mod 25 is appropriate to use on the discharge?

We have Ep & Cardiologist; If the Ep doctor does d/c same day as the cardioversion, I am not comfortable with adding the 25 mod since it is the same dx etc. Now if the cardiologist d/c the pt ie; chest pain, then I can see where the 25 mod could be ok to use.

You can't bill d/c on same date of service as a cath so I feel that this may be the same senerio. Does anyone know of any documention on this subject?

There are several opinions on this and I would like to feel confident about my decison before I persue this.

Thanks for any advice.

 

[jojo1550]

You would need to add the -25 modifier to the d/c code because the insurance would deny the service as bundled into the cardioversion. There are guidelines that previously came out from Medicare stating you do not need to have a separate dx code when you bill a procedure and E/M on the same date of service

 

[deeva456]

The discharge is bundled into the cardioversion especially if the cardioversion is done on an outpt basis. Unfortunatley you cannot bill for it separately, unless the d/c report shows it is a separate E/M service that not related to the cardioversion.

Dolores, CPC, CCC

 

[mmiciano]

Cardioversion

Agreed to above. The E&M is only billable if patient was admitted, whether observation or inpatient due to non-related reason to Cardioversion. Any elective outpatient procedure, the admission and discharge is globalled to the procedure when all done on the same day.