Ask Dr. Z

I have a cardiologist that is requesting documentation of reasoning for non-coverage/payment of 2nd diagnostic heart cath at time of "staged intervention". He strongly stresses that when a patient had a MI and "rescue intervention"(on thrombosed and stenotic RCA) and then scheduled for staged intervention(stenting) of qualified lesions in the LAD and Cirx, that a repeat LHC is the "standard of care" and should be charged. Timing between "rescue" cath and "staged" intervention was approx. 3 weeks. Per physician's H&P, procedural dicatation and discharge summary I cannot locate any additional documentation of change in patient status. In discharge report on this patient he states..."is 59-year-old gentleman who was admitted for straight stenting, and recent history of acute coronary syndrome, and RCA stent placement by Dr. in January of this year. He was admitted for planned PCI of the LAD and circumflex."  If possible would prefer reference sites/links to provide "offical" documentation to cardiologist. Thank you.