tci ED Coding & Reimbursement Alert - 2003 Issue 9

Reader Question: Any Doctor Can Bill for TPA

Question: We are having a problem getting reimbursed for coronary thrombolysis procedures (TNK) - code 92977 - when our ED physician performs them in the emergency room. I've spoken with other coders who've researched the subject and say that carriers won't reimburse for TNK in the ED because they consider it a cardiology service, so the cardiology department is probably billing it after the physician admits the patient. Because our ED physicians usually discuss the case with a cardiologist before they administer drugs, and the ED doctors assume the responsibility while the patient undergoes the procedure, I don't understand...

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