Question Stent rejection

Chelsea1

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Needing any input please. The office I code for is getting auths for caths. Once the doctor goes in and ends up doing a stent, the insurance is not covering that portion stating the auth did not cover that. My question is how would you to know under that auth what may or may not have been done? Should another auth be obtained for the stent and if so, how long do you have to obtain it? Not able to locate information relating to this on line.
Thank you
 
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226
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Coeur d'Alene, Idaho
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Our clinic authorizes both the cath and stent codes at the time the procedure is scheduled. We have a list of all possible codes that may apply when a patient has a heart cath and we try to get an authorization for all of them, that way the procedure has been authorized if the provider decides to intervene during the diagnostic cath.
 

bhargavi

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yes we do the same getiing auth for all possible codes at same time . only Humana does not authorize stent at the same time as cath but will give you retro auth once the stent or angio is done. some other insurances also give you retro auth for stents. I work for cath lab in facility so I let the cardiologist office know as soon as the case is done to get additional auth for stent
 
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