# Cardioversion & Discharge



## dpumford (Jul 23, 2009)

Hi!
Hope someone can help clarify this:

If a doctor does a cardioversion and then does a discharges on the same day, do you feel a mod 25 is appropriate to use on the discharge?

We have Ep & Cardiologist; If the Ep doctor does d/c same day as the cardioversion, I am not comfortable with adding the 25 mod since it is the same dx etc. Now if the cardiologist d/c the pt ie; chest pain, then I can see where the 25 mod could be ok to use.  

You can't bill d/c on same date of service as a cath so I feel that this may be the same senerio. Does anyone know of any documention on this subject?

There are several opinions on this and I would like to feel confident about my decison before I persue this.

Thanks for any advice.


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## jojo1550 (Jul 23, 2009)

You would need to add the -25 modifier to the d/c code because the insurance would deny the service as bundled into the cardioversion. There are guidelines that previously came out from Medicare stating you do not need to have a separate dx code when you bill a procedure and E/M on the same date of service


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## deeva456 (Jul 24, 2009)

The discharge is bundled into the cardioversion especially if the cardioversion is done on an outpt basis.  Unfortunatley you cannot bill for it separately, unless the d/c report shows it is a separate E/M service that not related to the cardioversion.  

Dolores, CPC, CCC


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## mmiciano (Jul 27, 2009)

*Cardioversion*

Agreed to above.  The E&M is only billable if patient was admitted, whether observation or inpatient due to non-related reason to Cardioversion.  Any elective outpatient procedure, the admission and discharge is globalled to the procedure when all done on the same day.


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