Wiki cath & stent, then returned for same

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maryann1224@bellsouth.net

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Need help please, patient had heart cath & stent due to stemi, then that same day went back in for heart cath and stent for chest pains:


this patient had a :(first session)

LHC/CORONARIES W/WO LV GRAM
STENT (BMS OR DES) LD (COR)
Clinical History & Appropriate Use
55-year-old male with a history of moderate 2 vessel coronary disease. He last underwent cardiac catheterization in January
2014. He presents now with acute anterior wall ST elevation myocardial infarction

a few hours later he returned for:

LHC/CORONARIES W/WO LV GRAM (next session)
STENT LC (COR)
Clinical History & Appropriate Use
55-year-old male admitted with anterior ST elevation myocardial infarction underwent stenting of his LAD. He developed post
infarct angina this morning and was taken back to the Cath Lab urgently to assess patency of his stent

i would bill both heart caths, and stents w/ Lc...&Ld, but what modifiers would i use? thank you for your help!
 
In this situation, you would use modifier -78: "Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period".
 
Does the 78 go on each code

& also what about the other heart cath that was done? I wouldnt report it too? I appreciate your help on this, it was getting rejected by our software company that scrubs our claims.

Thank you
 
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If the pt. had a change in status such as chest pains,etc. I would charge for the second cath but just charge coronary angios only-no lv. That's depending on the physician dictation and if he did inject the arteries and the lv.
 
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