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I have a MFM physician that performs intra utero surgery on fetus's. He asked if Cardiology could bill when they are in OR when for instance a meningiocele

  • 1.  I have a MFM physician that performs intra utero surgery on fetus's. He asked if Cardiology could bill when they are in OR when for instance a meningiocele

    Posted 11-03-2021 14:56
    Hi I have a MFM Physician that has a question about the ability for Cardiology to bill when they are present during a in-utero surgery and interpreting an Echo.  Can they bill this? They are also wanting to bill a consult but I said they did not meet the 3 R's to bill that

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    Mary Knigge
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  • 2.  RE: I have a MFM physician that performs intra utero surgery on fetus's. He asked if Cardiology could bill when they are in OR when for instance a meningiocele

    Posted 11-04-2021 09:24
    Mary
    If the cardiologist meets all the requirements for the 76825 - including a request to perform, performing the study, and then providing a report with interpretation - in general they should be able to bill.  I think where it might get sticky for the cardiologist is going to be that they are in the OR performing this study, and likely then in a hospital, so not sure what other modifiers they would need to attach (if any) and consideration of that 'facility' issue.  The cardiologist would need to sort that out with hospital billing, or submit this question to their own society/coding resources.  I would presume that there are cardiologists who perform echo at the time of surgery for other indications in children/adults, so the hospital probably has a mechanism for billing for their cardiology department when such things are being done. In terms of a consult I think I don't understand, because interpretation of the FE is included in the 76825 code? I assume they are not counseling the patient (under anesthesia), so what other 'counseling' or 'coordination of care' are they providing?  But again, maybe this is possible and I would suggest the cardiologist discuss with colleagues/hospital/compliance how they should bill for this study and interpretation and if any other E/M code (for consultation).  
    Vanita

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    Vanita Jain, MD
    Chair, SMFM Coding Committee
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