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Next Day FFR

  1. #1
    Default Next Day FFR
    Medical Coding Books
    So here is what!

    Day 1: Patient comes in for an elective left heart catheterization with coronary angiography and left ventriculogram. Procedure indication is chest pain. The MD does find a suspicious looking region in the LAD. He wants to perform an FFR of the lesion, but he is a diagnostic physician only and not credendtialed to do the FFR procedure. He asks an interventional doctor to look at the films and they agree FFR is warranted, but the interventional decides he cannot do the procedure today.

    Day 2: Interventional doctor performs a coronary angiogram of the LAD only, and also then performs FFR. The results show that the lesion is not flow limiting. No further intervention is rendered.

    Day 1: I charged 93510, 93543, 93545, 93555, 93556 per the documentation.
    Day 2: I am stuck! I cant charge for the FFR with 93571 unless I charge for a the coronary angiogram. But is this second coronary angiogram billable? There was no change in the patient condition and no change in the findings between the Day 1 and Day 2 angiogram.

    So, should I charge the patient for 93508, 93545, and 93556 along with 93571 on day 2?


  2. #2
    Wow this is a sticky one. Are the two physicians part of the same company? If so, I would think that you couldn't??? As you said there were no changes in the patients symptoms. I am thinking that if they are of two different practices you may be able to charge for the CORS on day 2. Maybe someone else with more experience can help shed some light on this one. If I find any information I will reply back.

  3. Default
    Looking at Day 2 only..........

    The deciding factor is: was the coronary done for diagnostic reasons or simply to assist in performing the FFR procedure? Day was was a general coronary angio, day 2 was an angio specific to the LAD.

    If it was diagnostic, then the 93508/93545/93556 can be separately coded in addition to the 93571.

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