If the pt is in observation status following the heart cath you cannot bill for it separately, unless they developed a new problem unrelated to the heart cath. We have 12 cardiologists and on occasion they have marked their billing for hospital visit or observation on the same day as the heart cath but we do not bill it out. They have to be reminded now and again not to bill E/M services on the same day as a heart cath. The exception to the rule is they are asked to do a consultation or in some cases critical care. I review their reports prior to posting the charges then will add modifier 25 if it is supported in their reports.
I hope this has helped,
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