Cardiology Coding Alert

Question: One of my cardiologist's patients has an implanted cardioverter-defibrillator for 427.1 (Paroxysmal ventricular tachycardia). Now this patient is undergoing hospital visits for pneumothorax and congestive heart failure (CHF). Should we use modifiers?


Kentucky Subscriber

Answer: If the cardiologist sees the patient in subsequent visits (99231-99233) unrelated to the global procedure associated with the cardio-defibrillator, you should append modifier -24 (Unrelated evaluation and management service by the same physician during a postoperative period) to the subsequent visit code.

Heads-up: You should add that modifier to each hospital visit with your diagnosis codes of CHF (428.x) and pneumothorax (512.x). You may need to include a note with each hospital CPT code that says, "Diagnosis different from the global diagnosis, which is 427.1."