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Melonyw

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I have a doc that did a right heart cath. The doc stated that the procedure usually takes around 30 mins to complete, but this procedure took over 3 hrs because he used different drugs to see which would bring down the patients hypertension. He is wanting to know how this could be billed so the allowable is higher?

Only thing I know is -22 modifier any other suggestions would be greatly appreciated!!!
 
well, I don't think 22 is appropriate. If your doc changed the meds up on another patient would it "normally" take the same amount of time? 22 modifier is when the procedure at hand, goes above and beyond, the usual typical procedure.

So, a "normal cath" per your doc takes 30 minutes. If this "complex cath" (with drug changes) typically takes 3 hours, then I don't think 22 is appropriate.

I hope that makes sense....
 
Maybe

Without seeing the op / procedure note it's hard to tell. But I think it's posible that you might be able to use a 22 modifier.

It's also possible that you have a significant, separately identifiable E/M code.

Without actually seeing the documentation it's hard to give a definitive answer in a case like this.

F Tessa Bartels, CPC, CEMC
 
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