Wiki Please help -repeat cardiac caths

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smiller

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Hello everyone - Does anyone know the rule on repeat cardiac caths for different dates of service? For example: A patient has a complete diagnostic cath on 11-27-13, but then the patient has to have another one maybe just 5 days later (12-2-13) with intervention (stent). Can you bill the full cath again 5 days later? Is it okay as long as there is medical necessity etc?

Any help is appreciated.

Thank you.
 
smiller said:
Hello everyone - Does anyone know the rule on repeat cardiac caths for different dates of service? For example: A patient has a complete diagnostic cath on 11-27-13, but then the patient has to have another one maybe just 5 days later (12-2-13) with intervention (stent). Can you bill the full cath again 5 days later? Is it okay as long as there is medical necessity etc?

Any help is appreciated.

Thank you.
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You can bill the second diagnostic only if you have documentation that the patients condition has changed since the first. or that the first was in some way insufficient. The guidelines are stated in the CPT book in the chapter "Coronary Therapuedic Services and Procedures".

HTH :)
 
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