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Observation w/Cath

  1. #1
    Default Observation w/Cath
    Medical Coding Books
    Is any of your doctors coding a Observation E/M along with there Catherization/Stent procedures?

    Is this routine for your doctors?


    I'm questioning this, because I recently was given the work load to audit the Cardiology Physicians here. And I'm seeing alot of Critical Care and Observation being coded along with these procedure.

    I haven't jumped into this audit 100% yet, but just looking at this on the surface. It looks like these E/Ms there trying to add are just the H&P work-up.


    Thanks for your input

    Daniel, CPC

  2. Default
    hELLO,

    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,

    Dolores, CCC-CPC
    Last edited by deeva456; 01-23-2010 at 11:00 PM.

  3. #3
    Default Thank You
    This makes perfect sense. Glad to see I'm on the right track.

    Thank You for your input.


    Daniel,CPC

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