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Diagnostic and Intervention 2 different doctors

B

bennieyoung

Guru
Messages
130
Location
Broomfield, CO
When there is one doctor in our practice doing a diagnostic cardiac catherization and a different doctor in our practice doing the intervention, same session, how can I report and get paid for both?
 
I guess I'm confused... I can't put two different doctors on the same claim and if I bill just for the cath on one claim for the doctor that does the cath then put the intervention on the other claim for a different doctor, same practice, same session... the intervention denies. I just wondered if anyone else was having this sort of issue and what they did about it. We have put the 59 modifier on the Cath and it didn't help.
 
bennieyoung said:
I guess I'm confused... I can't put two different doctors on the same claim and if I bill just for the cath on one claim for the doctor that does the cath then put the intervention on the other claim for a different doctor, same practice, same session... the intervention denies. I just wondered if anyone else was having this sort of issue and what they did about it. We have put the 59 modifier on the Cath and it didn't help.
Click to expand...


If the intervention is being denied, that should not be because of CCI (bundling) issues as the cardiac interventions are not components of heart caths (it is actually the other way around). What is the actual reason for the rejection? Could it be place of service, or medical necessity?

:confused:
 
First we billed for the Cath on a claim with one doctor and then had to create a seperate claim because a different doctor did the intervention. The second claim only had the intervention codes and the denial was CO107 The related or qualifying claim/service was not identified on this claim. I'm having trouble figuring out how to get the qualifying service on the intervention claim since the cath was performed by a different doctor.

Thanks for any thoughts on this!
 
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