Wiki Cpc

[krxan]

I work for a large cardiology group and it is their belief that when Medicare denies a cardiac cath for "not medically necessary", the entire claim should be written off. This happens when the results of the cath are negative. However, when I review the chart, it is noted by the doctor that the patient has angina and that diagnosis was the reason for performing the cath.

It is my understanding that when a test is positive, that is the diagnosis used for billing and when the test is negative, you should report the diagnosis or reason for requesting the test.

What's your opinion?

Thanks,
Roseann Kennedy, CPC

 

[Herbie Lorona]

Hi Roseanne,

I agree with you. If you dont have a diagnosis of that then you code for the reason or the symptoms

 

[krxan]

Thanks for your input.

Roseann