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Thread: Staged Stent procedures

  1. #1
    Join Date
    Apr 2007
    Location
    Jacksonville Florida
    Posts
    126

    Question Staged Stent procedures

    Good Morning List ~

    I attended a cardiology consultant meeting that some of my doctors set up last night. During the meeting some things were said that I believe to be incorrect and I would love other's opinions on this. Here's an example:

    Pt comes into ED with Acute MI, cardiology is asked to to take over care due to the MI. Pt brought to cath lab emergent and found during cath to have occlusion in LD and RC. Pt has renal failure, so dr decided to limit the amount of contrast and only stents RC and schedules the pt 2 weeks out to come back for stent to the LD. The pt is stable and with no new symptoms during the 2nd stent placement......

    Now, I've always understood this 2nd stent to be a "staged" procedure. Some of my docs don't understand this from a billing standpoint and they are turning in for me to bill another LHC which I do not. During this meeting last night, I asked the consultant this very question. I was told that I could bill for the 2nd LHC and add mod -58. I do not agree to this.
    Jammie Barsamian, CPC, CCC, CEMC, CCS-P, CPMA

  2. #2
    Join Date
    Apr 2007
    Location
    Green Bay
    Posts
    401

    Default

    Quote Originally Posted by jlb102780 View Post
    Good Morning List ~

    I attended a cardiology consultant meeting that some of my doctors set up last night. During the meeting some things were said that I believe to be incorrect and I would love other's opinions on this. Here's an example:

    Pt comes into ED with Acute MI, cardiology is asked to to take over care due to the MI. Pt brought to cath lab emergent and found during cath to have occlusion in LD and RC. Pt has renal failure, so dr decided to limit the amount of contrast and only stents RC and schedules the pt 2 weeks out to come back for stent to the LD. The pt is stable and with no new symptoms during the 2nd stent placement......

    Now, I've always understood this 2nd stent to be a "staged" procedure. Some of my docs don't understand this from a billing standpoint and they are turning in for me to bill another LHC which I do not. During this meeting last night, I asked the consultant this very question. I was told that I could bill for the 2nd LHC and add mod -58. I do not agree to this.
    I agree with you. If the patient has no new symptoms and only being brought back specifically to do the intervention on stenoses that they already know about, it isn't diagnostic. Can only bill the intervention. The cath placement and angiography would be considered an integral part of the stent services.

    Jessica CPC, CCC

  3. #3

    Default Stage Sten procedure

    Procedure done on RC and LD are two separate procedure, on two separate date , on separate part. It not considered stage procedure, hence, mod -58 STAGED OR RELATED PROCEDURE, do not apply (stent on RC and LD) two different procedure.

    To consider using mod -58 it may be cenessary to indicate that the performance of a procedure or service during the POSTOPERATIVE period:
    a) planned and anticipated (stage)
    b) more extensive than the ORIGINAL PROCEDURE
    c) for the therapy following a (ORIGINAL) surgical procedure

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