Cardiology Coding Alert

Reader Question:

93454's Global Period Affects Discharge

Question: May I report 99238, discharge from hospital, on the same date as coronary angiogram? Medicare says discharge is covered in the surgery's global days, but coronary angiography has 0 global days.Codify MemberAnswer: A 0-day global period means that Medicare will bundle all E/M services on the surgery date into the surgical code.As a result 99238 (Hospital discharge day management; 30 minutes or less) is bundled into 93454 (Catheter placement in coronary artery[s] for coronary angiography, including intraprocedural injection[s] for coronary angiography, imaging supervision and interpretation).The classification XXX (Global surgical rules do not apply) means that the service is truly free of global surgical bundling issues, and you can separately report services performed on the same date as the surgical procedure (such as E/M services).
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