tci ED Coding & Reimbursement Alert - 2001 Issue 5

Reader Question: Thrombolytics

Question: There is confusion in our emergency department about billing for thrombolytics. Does Medicare pay for them? Should they be billed with critical care?Florida SubscriberAnswer: Medicare does not pay for the physician work component of thrombolytics. But other payers do. When coding for a non-Medicare stroke patient who presents to the ED with myocardial infarctions, use 37195 (thrombolysis, cerebral; by intravenous infusion) and 92977 (thrombolysis, coronary; by intravenous infusion). In most non-Medicare cases the physician will likely charge for critical care if thrombolytics are provided in the ED for those payers that recognize 92977 or 37195 with critical...

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