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Cardioversion & Discharge

  1. Smile Cardioversion & Discharge
    Medical Coding Books
    Hope someone can help clarify this:

    If a doctor does a cardioversion and then does a discharges on the same day, do you feel a mod 25 is appropriate to use on the discharge?

    We have Ep & Cardiologist; If the Ep doctor does d/c same day as the cardioversion, I am not comfortable with adding the 25 mod since it is the same dx etc. Now if the cardiologist d/c the pt ie; chest pain, then I can see where the 25 mod could be ok to use.

    You can't bill d/c on same date of service as a cath so I feel that this may be the same senerio. Does anyone know of any documention on this subject?

    There are several opinions on this and I would like to feel confident about my decison before I persue this.

    Thanks for any advice.

  2. Default
    You would need to add the -25 modifier to the d/c code because the insurance would deny the service as bundled into the cardioversion. There are guidelines that previously came out from Medicare stating you do not need to have a separate dx code when you bill a procedure and E/M on the same date of service

  3. Default
    The discharge is bundled into the cardioversion especially if the cardioversion is done on an outpt basis. Unfortunatley you cannot bill for it separately, unless the d/c report shows it is a separate E/M service that not related to the cardioversion.

    Dolores, CPC, CCC

  4. #4
    Default Cardioversion
    Agreed to above. The E&M is only billable if patient was admitted, whether observation or inpatient due to non-related reason to Cardioversion. Any elective outpatient procedure, the admission and discharge is globalled to the procedure when all done on the same day.
    Last edited by mmiciano; 07-27-2009 at 06:21 PM.

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