Cardiology Coding Alert

Question: Can I bill for an office visit by a cardiologist and an electrophysiologist (EP) on the same day? The interventional cardiologist from our clinic also wanted the patient to see the EP in our clinic on the same day for his ongoing heart failure care. The EP has never seen the patient before. Can we bill both visits?

Tennessee Subscriber

Answer: Because both physicians are registered as cardiologists in the eyes of CMS, only one of them should bill for the E/M service.

If the cardiologist and the EP think that they can meet the definition of CMS' concurrent care regulations, you can bill for both visits. But you should realize that the administrative burden associated with proving the need for concurrent care is considerable. Therefore, you'll find it more practical to bill for the combined work of both doctors under the EP's name and number as a consultative service.

You Be the Coder and Reader Questions were prepared with the assistance of Jim Collins, ACS-CA, CHCC, CPC, CEO of the Cardiology Coalition and compliance manager for several cardiology groups around the country; Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CHCC, president of CRN Healthcare Solutions, a coding and reimbursement consulting firm in Tinton Falls, N.J.; and reviewed by Jerome Williams Jr., MD, FACC, a cardiologist with Mid Carolina Cardiology in Charlotte, N.C.