Wiki Fractional Flow Reserve - 93571

[porkupyne]

Our practice recently gained a non-interventional cardiologist (Dr. Presser). He performed a LHC w/ LVgram (93458) on a patient and wanted to evaluate flow reserve. He called in our interventionalist (Dr. Mikdadi) and the flow reserve was done by him. I am trying to bill for the flow reserve, but want to make sure I get this right. Since 93571 is an add-on code I am getting flagged by our billing software looking for the 93458. However, as it was done by two different doctors, it is on two different bills. Am I correct in billing it this way, and if so where can I find documentation regarding this? Athena (our EMR) won't override the claim being sent with 93571 only unless I can provide documentation.

Just to recap:
Same patient, same day, same session in the cath lab.
Dr. Presser 93458-26
Dr. Mikdadi 93571-26

Thanks!

 

[lovelyadd]

We've had this problem and was also on Athena and had to have someone override it. FFR can only be performed by an interventionalist and an FFR is only an add on code, doesn't make sense.