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Two Questions: Non-Loop Event Monitor/ Reduced Cardiac Cath

  1. #1
    Default Two Questions: Non-Loop Event Monitor/ Reduced Cardiac Cath
    Clearnace Sale
    Two questions from someone pretty new to Cardiology:

    1. Pt presents for a non-loop event monitor (typically worn for 30 days) and discontinues wear after two days, trading it for a loop monitor instead since she said the non-loop made too much noise at work. Would you bother billing 93012/93014 with a modifier for two days? How would you code the non-loop portion since it was no where near 30 days?

    2. Patient had an unsuccessful cardiac cath due to anatomical reasons. Would you bill the cath modified 52? Or bill an alternative code even though it wasn't the procedure the patient presented for?

    Last edited by Belinda Frisch; 03-19-2010 at 01:43 PM.
    Belinda S. Frisch, CPC, CEMC
    Author of "Correct Coding for Medicare, Compliance, and Reimbursement"

  2. #2
    Default Reduced Cardiac Cath
    Why wouldn't you use a modifier 53? I would definately bill the cath with a modifier 53. If it was completely unsuccessful use 53, if the patient received some benefit bill it with the modifier 52.

    Danielle Bynum, CPC

  3. #3
    Default Not the reason...
    I wouldn't use 53 because it isn't appropriate.

    Mod 53 indicates that the physician elected to terminate a surgical or diagnostic procedure due to the patient's well-being.

    The patient's well-being wasn't the issue and the physician didn't elect to terminate, he just couldn't perform the cath because he could not get through. Hence, a reduced procedure.
    Belinda S. Frisch, CPC, CEMC
    Author of "Correct Coding for Medicare, Compliance, and Reimbursement"

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