Wiki Charging and E/M with Heart Cath on pt transferred from another facility

[sfurber]

I need to know if I can charge a History and Physical E/M charge on a patient that is being transferred from another medical facilty for a heart catherization. This is from another hospital's emergency department or from an inpatient stay. My doctor goes ahead and dictates the H&P but I am not sure if I can charge it or not.

 

[AmandaBriggs]

Here is the NCCI global reminder for these codes: Global Days: 000 - Endoscopic or minor procedure with related preoperative and postoperative relative values on the day of the procedure only included in the fee schedule payment amount; evaluation and management services on the day of the procedure generally not payable.

That being said, if you pull out all of the info in the E/M that pertains to the cath and there is enough left over to meet criteria for an E/M then you can code it with a modifier 25. You could also bill the E/M if it was unrelated to the procedure. An E/M can also be reported if the patient has chronic medical conditions or take prescriptions that affect the risks of the procedure and the documentation needs to support this.