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Cardiology Coding Alert

Reader Question: Thrombin Injections

- Published on Thu, Nov 01, 2001
Question: A patient underwent left heart catheterization and subsequently developed a pseudo-aneurysm of the femoral artery, which the cardiologist treated with a thrombin injection. How should I code the injection?                      

Maryland Subscriber  
Answer: Whether the injection can be billed at all depends on the place of service. If the injection was performed while the patient was in the hospital, it will not be separately reimbursed because it is considered part of the hospital service. The cardiologist may be able to bill for an E/M service if the components of a visit were performed and documented.
If the injection took place in the office, 90782 (therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular) or 90784 ( intravenous) may be billed if the cardiologist only performed the injection and did not provide E/M services (other than a basic preinjection evaluation). If the cardiologist provided and documented a separate E/M visit, the appropriate new or established patient office visit should be billed. The injection is bundled with the E/M and should not be billed separately.  
You Be the Coder and Reader Questions answered by Sueanne Bicknell, RHIA, CPC, CCS-P, compliance administrator at CPR-Heart Place, a group practice with 65 cardiologists in Dallas; Gay Boughton-Barnes, CPC, MPC, CCS-P, chief medical compliance officer for the University of Oklahoma Medical Center in Tulsa; Susan Callaway, CPC, CCS-P, a coding and reimbursement specialist and educator in North Augusta, S.C.; Diane Elvidge, CPC, a coding and reimbursement specialist with Princeton Reimbursement Group in Minneapolis; Martha Gerant, CPC, a coder with Cardiology Services, an 11-physician practice in Shawnee Mission, Kan.; Nikki Vendegna, CPC, a cardiology coding and reimbursement specialist in Overland Park, Kan.; and Marko Yakovlevitch, MD, FACP, FACC, a cardiologist in Seattle.

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