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Please Help

  1. #1
    East Stroudsburg
    Default Please Help
    Medical Coding Books
    Hi, I have 2 questions,

    1. My doctor did a LHC on a patient yesterday, it took a long time and the doctor had some problems, the patient needed a stent in the RCA he also needed PCI in the LCX but doctor didn't want to do it at the same time because the fluoroscopy time was almost 27 minutes so he brought hime back to the cath lab today to do that procedure. The procedure was unsuccessful, doctor couldn't get the balloon inflated. I am not sure how to bill for that second procedure. I don't think I can bill for the LHC because it was a staged procedure, would I just bill for the PCI with a modifier? I really appreciate any help on this.

    2. My doctor will be going away this summer and we are trying to figure out if we can still do pacemaker checks in the office with our nurse practitioner even if the doctor isn't in the office.

    Again, thank you for any help on these matters.

    Christine Berman

  2. #2
    You would be correct not to bill the LHC on day two because it was staged. I would say that if the doctor was able to get a balloon to the lesion but unable to deploy then you could bill the balloon code with a modifier for discontinued procedure. However, if he was not able to get the balloon to the vessel and only got that far with a wire/sheath, then I would not bill for the balloon. These types of cases you should check your employer's policy and use best judgement.
    A.Dimmitt, CPC, CIRCC
    Durham, North Carolina

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