Wiki Second Heart Cath not billable as diagnostic with CPT 33967 IABP?

[coffee2day]

Hello,

If a patient had a diagnostic coronary angiogram 93456 and the very next day had an IABP placed 33967 and the provider is billing for another cardiac cath 93454 this time (this is all in preparation of a CABG to be done).

I feel the second day we can't bill 93454 as the cardiac cath is not diagnostic, statement of left coronary circulation no changes post IABP (but did have full findings documented of all left coronary arteries).

Any advice would be greatly appreciated, thank you!

 

[Jim Pawloski]

Hello,

If a patient had a diagnostic coronary angiogram 93456 and the very next day had an IABP placed 33967 and the provider is billing for another cardiac cath 93454 this time (this is all in preparation of a CABG to be done).

I feel the second day we can't bill 93454 as the cardiac cath is not diagnostic, statement of left coronary circulation no changes post IABP (but did have full findings documented of all left coronary arteries).

Any advice would be greatly appreciated, thank you!

In your case, since the patient had a previous diagnostic cath, I do not bill for the second cath, unless there is some change in the patient's status. There has to be documentation that the patient is having chest pain, or their hemodynamics situation has changed before the second procedure to be able to bill for the repeat study.
HTH,
Jim Pawloski, CIRCC