December 13, 2012
I heard at a seminar that diagnostic angiograms performed at the same operative session as a stent or angioplasty can never be billed. Is that true?
No that is not exactly true. According to CPT, diagnostic angiograms performed at the time of an interventional procedure may be separately reported if:
- No prior catheter-based angiographic study is available and a full diagnostic study is performed and the decision to intervene is based on the diagnostic study OR
- A prior study is available but as documented in the medical record:
ο The patients condition has changed since the prior study
ο There is inadequate visualization of the anatomy and/or pathology
ο There is a clinic change during the procedure that requires a new evaluation outside the target area of intervention
One of these conditions should be documented in the operative note; ideally in indications section. It must be clear that one of these conditions existed to justify a diagnostic study at the same time as an intervention.