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TAVR two consultations required

  1. #1
    Exclamation TAVR two consultations required
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    Hi - per TAVR requirements, two consultations are required. We have the consultations performed, not sure if this is standard, by the same group.

    Can you bill both consults and if so, do you just have to appeal it? Or is only one billable?

    Is there any info that can be provided please in regards to this?

    Thanks...

  2. #2
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    Quote Originally Posted by nlbarnes View Post
    Hi - per TAVR requirements, two consultations are required. We have the consultations performed, not sure if this is standard, by the same group.

    Can you bill both consults and if so, do you just have to appeal it? Or is only one billable?

    Is there any info that can be provided please in regards to this?

    Thanks...
    Yes two consults are required. If the patient is seen by two physicians in one day only one may be billed.

    We are the surgeons office. All our TAVR patients that are seen have 2 consults. Both billable if done on different days

  3. Default Tavr 2nd opinion denied as bundled
    Since a TAVR requirement is to have two Cardiovascular Surgeon consults, how would the 2nd opinion Consult be billed when it is completed the day before the procedure?

    The Consult which was completed one day prior to the procedure is bundling to the surgery, and I would like to know what Modifier would be appropriate. Since the TAVR is a zero day global, it

    does not allow for MOD 57, and since the EM was not done on the day of the procedure, MOD 25 cannot be used.

    Thank you . . .

  4. #4
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    Quote Originally Posted by jwilding@san.rr.com View Post
    Since a TAVR requirement is to have two Cardiovascular Surgeon consults, how would the 2nd opinion Consult be billed when it is completed the day before the procedure?

    The Consult which was completed one day prior to the procedure is bundling to the surgery, and I would like to know what Modifier would be appropriate. Since the TAVR is a zero day global, it

    does not allow for MOD 57, and since the EM was not done on the day of the procedure, MOD 25 cannot be used.

    Thank you . . .

    We have Julie Panter coming to our office next week. This question has been brought up I will get confirmation from her and get back to you.

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