Ask Dr. Z

I received the following statement from a cath lab director: "What I saw about injections integral to a procedure is that for cardiac cath, the only injections integral to the procedure are the basic sedations, which we don’t charge for. Anything else such as NTG given intracoronary, metopralol IV, Integrillin bolus, and then infusion are not integral to every case. Those are very specific instances and in my mind it seems we should be able to charge for them." My feeling is that separate billing for the administration of these drugs with code 96374 or 96365 would not be appropriate when administered during the course of a cardiac cath or a coronary intervention due to well established NCCI bundling edits. The reason why I say that is that the cardiac cath/coronary intervention would not be considered complete or performed properly on a patient without the performance of these infusions, therefore integral to the main procedure. Is this take more conservative than it should be? Do you agree with it, or is there another code that should be considered?