Wiki Time between diagnostic procedures

[kimmyjwright]

I have been told that the time between cardiac caths is 30 days in order to be paid. I do realize that if there is a new symptom, the second diagnostic is allowed. I need to know if there is a "30 day rule" on this and where I might find it...I have not been able to find a specific indication of time, and I need to see it in writing. Thanks!

 

[Margaret Morgan]

I have not seen a "offical guidelines", but my MAC carrier did have this in the general information section, under utilization guidelines.

Utilization Guidelines
Diagnostic coronary angiography may not be billed when performed during percutaneous coronary intervention, if it has been previously performed within the past six months resulting in the decision for the beneficiary to undergo the specific interventional procedure.

Sources of Information and Basis for Decision
This bibliography presents those sources that were obtained during the development of this policy. CGS is not responsible for the continuing viability of Web site addresses listed below.

Hopes this helps some.