mitzimarie2001@yahoo.com
Contributor
Scenario: Patient presented to emergency room after syncopal episode and found to be in atrial fibrillation. Patient has never been told that she has any type of arrhythmia. Overnight patient was placed on telemetry and it was noted that she jumps from sinus rhythm to atrial fibrillation to atrial flutter to junctional rhythm. She has had numerous pauses as long as 4 to 5 seconds long.
Cardiologist was asked to consult and determined that dual chamber permanent pacemaker implantation would be performed. Procedure was performed the same day as the consult.
My question: Since procedure code 33208 has a 1-day preoperative period and a 90-day postoperative period included in the fee schedule payment amount, I need some clarification on whether I can bill for E/M charges. The patient was admitted through the ER on 07/02 and was discharged on 07/08. The insurance is Anthem Blue Cross. My cardiologist is telling me to bill these charges:
07/03 - 99222-25
07/03 - 33208-KX
07/03 - 36005-XU
07/03 - 75820-26, XU
07/03 - 99152
07/04 - 99232
07/05 - 99232
07/06 - 99232
07/07 - 99232
07/08 - 99232
I'm thinking the E/M charges are going to be denied as global. However, since the patient presented to the E/R for syncope on 7/02, and my cardiologist was asked to Consult on 7/03 and that is when it was determined that the patient needed a pacemaker, is there at least a way that she can get paid for that initial consult on 7/03? On the subsequent E/M charges - the notes for each day are described as "Cardiology Progress Notes," and describe post-op treatment. I'm thinking that the notes do not describe treatment of the underlying condition; it appears to be for post-op care. I just don't want to miss any modifiers that may help get the E/M charges paid.
Thank you,
Mitzi
Cardiologist was asked to consult and determined that dual chamber permanent pacemaker implantation would be performed. Procedure was performed the same day as the consult.
My question: Since procedure code 33208 has a 1-day preoperative period and a 90-day postoperative period included in the fee schedule payment amount, I need some clarification on whether I can bill for E/M charges. The patient was admitted through the ER on 07/02 and was discharged on 07/08. The insurance is Anthem Blue Cross. My cardiologist is telling me to bill these charges:
07/03 - 99222-25
07/03 - 33208-KX
07/03 - 36005-XU
07/03 - 75820-26, XU
07/03 - 99152
07/04 - 99232
07/05 - 99232
07/06 - 99232
07/07 - 99232
07/08 - 99232
I'm thinking the E/M charges are going to be denied as global. However, since the patient presented to the E/R for syncope on 7/02, and my cardiologist was asked to Consult on 7/03 and that is when it was determined that the patient needed a pacemaker, is there at least a way that she can get paid for that initial consult on 7/03? On the subsequent E/M charges - the notes for each day are described as "Cardiology Progress Notes," and describe post-op treatment. I'm thinking that the notes do not describe treatment of the underlying condition; it appears to be for post-op care. I just don't want to miss any modifiers that may help get the E/M charges paid.
Thank you,
Mitzi
