KATHLEEN Posted Thu 25th of April, 2013 17:28:46 PM
If patient has s STEMI treated medically before cardiac cath intervention can we still use 99241?
SuperCoder Answered Thu 25th of April, 2013 22:22:39 PM
99241 is a consult code, which Medicare and many other payers no longer cover. If the patient’s payer covers 99241, then whether it’s reportable would depend on the nature of the service and the documentation.
But do you mean 92941? This isn’t authoritative, but unofficially coding consultants have said that when the AMA was asked, the AMA presented the question to the ACC, which said an acute example would be ballooning within 90 minutes of first medical contact. This is similar to the industry’s door-to-balloon 90-minute goal, which is also referenced in AMA’s CPT Changes 2013 clinical description of 92941. Until something is officially published, checking with the payer is the surest way to match the payer’s understanding of the code.