Wiki Cath/Stent for patient we've never seen

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meganbruce

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Am I just completely off my rocker for thinking this is not billable????

Cardiologist meets a patient at the hospital for LHC with possible intervention. Only thing is the patient was referred by another doctor and we have NEVER seen the patient. The cardiologist does not do an H&P in the hospital... just does the cath. I can't bill this... correct?

HELP!!
 
mbruce38 said:
Am I just completely off my rocker for thinking this is not billable????

Cardiologist meets a patient at the hospital for LHC with possible intervention. Only thing is the patient was referred by another doctor and we have NEVER seen the patient. The cardiologist does not do an H&P in the hospital... just does the cath. I can't bill this... correct?

HELP!!
Click to expand...

I think you can bill for the HC, but that's it.

Jim Pawloski, CIRCC
 
If your physician did the procedure, you can bill the professional side of service, It does not matter if they are a new or established patient, or if a consult was done. this is not an E/M service.
 
Jim,

Thanks for your response, but how could we bill for a heart cath when we've never seen the patient and it's a referral, not a consult. For some reason I just can't wrap my brain around this. I can understand if our cardiologist was on call and had an ER pt needing a cath and/or stent, but not a REFERRED patient. Is there any literature on this. I am coming up empty handed and it's very frustrating....
 
I understood what you meant, I was just clarifying: If your Physician did the procedure(does not matter if referred) you can bill for the service, LHC -26. I code for a cardiologist and we have many referrals. and they are billable.
 
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