Can an E/M code be billed with a heart cath and an coronary cath/angiography?

re: Can an E/M code be billed with a heart cath and an coronary cath/angiography?

It may be appropriate to bill the E/M separately, particularly when the heart cath is an unplanned emergency. The E/M should be billed at the appropriate level with modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service. In an unplanned cardiac cath., the cardiologists exam is the first evaluation the patient has had for the condition and is medically necessary. If the procedure is planned and scheduled already, the H&P would be included in the procedure code and not separately billed.