# CATH LAB Procedures- Sample Billing Forms



## econnolly (Oct 17, 2012)

Hi Coders,
We are redesigning our Cardiac CATH LAB "Encounter form/Billing sheet/Superbill/Claim form" (a list of codes for the Physician's work/Professional charges) and I would really appreciate some examples of what works for other practices.

Do any of you still use a paper form? 

If so, would you mind faxing a copy to me at:
781 744-5267

or via email at:
elizabeth.m.connolly@lahey.org

Thank you in advance!

Elizabeth Connolly, CPC


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## jewlz0879 (Oct 22, 2012)

Done. See what you think


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## econnolly (Oct 23, 2012)

*Thank you!*

Thank you Julie!

Elizabeth


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## kdixey (Nov 6, 2012)

Julie , 
Could you possibly forward a copy to me as well?
karen_dixey@apms.biz or fax 215-464-9034
Thanks


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## em2177 (Nov 6, 2012)

Would you be able to send me a copy as well? Im in the process of updating our forms....
Thank You!  

Email: pandm2009@att.net


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## bdempsey (Nov 7, 2012)

Julie:

Could you fax one to me as well?  610-956-0042

Thanks!

Barb


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## jzick01 (Dec 5, 2012)

I would love one as well. Would you also happen to have one for EP procedures? 

Thanks!

julie.zick@nhrmc.org


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## jewlz0879 (Dec 5, 2012)

Crap, I totally didnt see these requests. I'll get them to y'all.


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## maryann1224@bellsouth.net (Dec 6, 2012)

hi julie, can you include me too?  thanks..
maryann1224@bellsouth.net


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## jewlz0879 (Dec 12, 2012)

I don't have this scanned yet. Thought I did. I actually had to fax. I will fax to those who left their number. Sorry.


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## bhjerrell (Dec 12, 2012)

Can I get a faxed copy???  540-582-5934 Thank you so very much

Betty Jerrell, CPC


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## karbaker (Dec 12, 2012)

Julie could I also get a copy

thanks Karen
kbaker@ccvmg.com
or fax 661-616-9273


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## tbanks75 (Dec 12, 2012)

*Could you fax me one....*

I would like one faxed as well, if you don't mind.


-Tracy Banks, CPC
CarolinaEast Heart Center

Fax : 252-633-1905

Thanks for your help!!!!!!!!!


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## squeaker7 (Dec 17, 2012)

I'd love one too!  Fax to Angella at 620-271-3166 if you could please!

Thanks!


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## swakeel (Dec 26, 2012)

Hell oJulie

Can you email one swakeel@comcast.net or fax 559-2276405...thank youuuuuuuuuuu


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## karbaker (Dec 27, 2012)

Julie , I would love a copy also

661-616-9273
thanks a bunch

Karen
kbaker@ccvmg.com


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## shirlee41 (Dec 27, 2012)

Julie, please send me a copy also,  thank you.

shirleehudgins@gmail.com
or fax to
281-338-4445


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## jewlz0879 (Dec 28, 2012)

Sorry. I keep getting busy with other things and have forgot to send these. I will be sending them shortly. Watch your fax!


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## jtb57chevy (Dec 28, 2012)

Hi Julie, 
Would you mind faxing one to 606-325-0375?  

Thanks so much!


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## DORAZIO73 (Jan 1, 2013)

Could you please send to me as well at dorazio73@aol.com
Thank you and Have a Happy New Year


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## sharper (Jan 2, 2013)

I would appreciate a copy also!
 fax 469 916-8094
email sharper@civadallas.com

Thanks and happy new year,
Susan


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## kdoughty (Jan 2, 2013)

Julie,
Can you fax to  me also.  740-779-8559.  Thanks!


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## psedgley (Jan 2, 2013)

*can you fax me a copy of cathlab charge sheet?*

Hi Julie, can you fax me that billing sheet example for cath lab too? is there one for ep too? my fax is 916 453-4212
I would really appreciate it!! 
thanks, paula

wow is this really from 07? sorry, is there a current 2013 cathlab charge sheet example somewhere? i will keep looking!


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## BARMSTRONG (Jan 2, 2013)

*Cardiology sheets*

Julie, could you email one also,

barbara.armstrong@ omhs.org
thanks


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## lthompson (Jan 2, 2013)

Could you please fax one to me as well at 803-435-5259 attn: Lauren.
Thank you so much!


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## jewlz0879 (Jan 2, 2013)

psedgley said:


> Hi Julie, can you fax me that billing sheet example for cath lab too? is there one for ep too? my fax is 916 453-4212
> I would really appreciate it!!
> thanks, paula
> 
> wow is this really from 07? sorry, is there a current 2013 cathlab charge sheet example somewhere? i will keep looking!



No, this is current. I think I do. I'll se what I have.


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## pdrgos (Jan 3, 2013)

Could you forward a copy for me too. my fax is 410-760-1870--thanks, Pam


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## jcee (Jan 4, 2013)

Can you fax a copy to 972-566-5927?  Thank you so much!


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## DORAZIO73 (Jan 7, 2013)

Could you please send to me dorazio73@aol.com
Thank you.


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## btaz (Jan 7, 2013)

Hi Julie, 
Can you please fax this to 920-320-4155 as well.   Thanks so much!!!!

Barb Zill, CPC, CCS-P


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## sweetlish (Jan 7, 2013)

Can you please send me a copy of your charge sheet also?  Thank you!!!

Fax is (678) 997-2431

email is 
astanford@ngheartcenter.com


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## DORAZIO73 (Jan 8, 2013)

Could you please fax me a copy attention Ginger 631686-7666...Thank you.


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## vsmith (Jan 8, 2013)

can you email me a copy of your superbill at vsmith25@roadrunner.com thanks


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## WendyTurko (Jan 8, 2013)

Julie, can you please share with me too?
wendy.turko@cvcde.com or fax: 3026442018

thank you


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## Itcoder09 (Jan 9, 2013)

Julie, could you please include me in your list ?
Thank you.
fax 305 227-3151

William Anguetta, CPC


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## gnp001 (Jan 10, 2013)

Hi Julie,

If it wouldn't be too much trouble could you email me the sheet as well please?

Thanks so much!

billing.eastcoastcardiology@gmail.com


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## cypress4334 (Jan 31, 2013)

Your just a wealth of information Julie  Would you mind faxing me as well?

713 722 7939 attn Donna


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## kimberlybaggott@gmail.com (Jan 31, 2013)

*cath form*

Could I get a copy of that sent to kimberlybaggott@live.com

thanks


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## jewlz0879 (Feb 1, 2013)

The one I had was for last year. I do not have a new one for 2013. Sorry.


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## Revenuecycle (Feb 4, 2013)

*Me To!!*

Can a copy be sent to ssullivan@chmed.org as well.

Thanks so much.


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## mjoshi (Feb 4, 2013)

*Need Copy of Billing Sheet*

Could you please send me copy of Cardiac CATH LAB "Encounter form/Billing sheet/Superbill/Claim form" (a list of codes for the Physician's work/Professional charges) including new 2013 Intervention codes @ escmitra@hotmail.com. Thanks


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## aforsythe (Feb 27, 2013)

Hello Julie,

Would it be possible to fax to me also? (717) 724-6461.

Our physicans can not agree on the two we made designed so looking for other suggestions.

thank you


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## jewlz0879 (Feb 27, 2013)

I don't have one for 2013 - my apologies. My original reponse was for 2012 SBs. I will be creating a new one but _do not _ have it at the moment due to other commitments. 

Thanks!


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## nancy.anselmo@ccrheart.com (Feb 27, 2013)

Can you fax me a copy also Thanks Julie 
Nancy 585-720-0776


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## Four Corners (Jun 5, 2013)

**

hello Julie,
If you could fax me a copy as well, I do appreciate it. 505.327.9688
Thanks


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## mdbillingca (Jun 22, 2013)

I would be very thankful if you would share.  Thank you in advanced. mdbillingca@yahoo.com or fax is 661-322-2330.


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## rparikh (Jul 22, 2013)

Can you please fax me @ 805 306 0304
 Thank you


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## rwhitm (Oct 23, 2013)

*Superbill Copy*

Could I also receive a copy via fax? 417-328-6667
Thank you so much!
Renee


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## vsmith (Oct 23, 2013)

Julie , can you email me a copy of your sperbill ? vsmith25@roadrunner.com thanks


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## Four Corners (Oct 24, 2013)

*superbill copy*

If you could fax me a copy as well@505-327-9688....Thank you!


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