Wiki Really need some directon on this one

[suela923@aol.com]

Although I understand the doctor wanting to see where he is going to administer theraspheres I don't see where the repeat angiograms meet any of the criteria for billing diagnostic angiogram at the time of this intervention.



We are starting to do therasphere pretreatment evaluations followed by the actual therasphere administration on another date of service.

During the pre-treatment we did several angiograms including a celiac and anterior division right hepatic. Then on the day of the administration the doctor repeated these same angiograms with the phrase "was performed to evaluate for tumor vascularity and new/recurrent collateral flow". Are these angiograms billable again? I'm confused. If they were done as pre-treatment doesn't that mean we can't bill again unless there was a change in patient's condition?



Thanks,
Sue

 

[mzachel]

It depends on how long ago the initial diagnostic angio was performed. This is a grey area. Changes in patients condition can also justify a new diagnostic angio. Without seeing the report I can't clarifiy if it is truely diagnostic. Read the patient history and look for any new finding from MRI's or CT's recently this might help.
Also if there has been a period of months between angio's and/or embolizations then a new diagnostic angio can be justified. Angiograms are still considered the best way for the physicians to find out which vessels are feeding the lesions.
And really read the findings, look for anything that would indicate the physician found something new since the previous angio.