Wiki Hospital admission & cath

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EmilyDingee

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I would love some feed back on this.
I was just asked to research if it is appriopriate to bill hospital h&p with same day cath. I am initially thinking if it is not planned and the work is done absolutley. However i am coming across lots of information on cms stating that this preprocedural work up is included in this minor procedure.
Are you billing hospital admissions seperate from catheterizations when the patient is admited and then cathed?
 
You're on the right path. If the heart cath was planned you should not bill for an H&P. If, however, H&P was performed and it was determined patient needed heart cath, then you can bill the H&P with appropriate modifier.

HTH
 
What if the doctor performing the cath has never seen the patient before? ex, a cardiologist from a different practice does not do caths so he refers the patient to the Interventional cardiologist to do the cath. The IC doc does not see the patient for the first time until he is at the hospital prior to the procedure. We have been billing a new patient visit with 25 modifier with the heart cath as he does do an H&P prior to the procedure.

Janet
 
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