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  #1  
Old 03-30-2009, 02:23 PM
uncapooh uncapooh is offline
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Question Medicare Reimbursement for EKG's

HI ALL...I NEED SOME HELP HERE. I AM A NEW BILLER/CODER AND I'M HAVING TROUBLE GETTING REIMBURSED FOR EKG'S DONE IN DOC'S OFFICE.

IS THERE A V CODE OR SPECIAL MODIFIER THAT I NEED TO SUBMIT WITH CODE 93000? ANY AND ALL HELP WOULD BE GREATLY APPRECIATED
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Old 03-30-2009, 02:36 PM
Herbie Lorona Herbie Lorona is offline
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What is the denial reason? If you have a covered diagnosis and have box 17 and 17b filed in then there really shouldn't be any problems!
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Old 03-30-2009, 02:43 PM
jillmtom jillmtom is offline
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Hello:

The V72.81 - Pre-operative cardiovascular examination can be used for a pre-op EKG in the absence of a sign or symptom.

Check with your Medicare carrier to see if they have a policy on EKG to ensure you are coding and listing your diagnoses correctly on the claim form.
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Old 03-30-2009, 03:44 PM
Jackie Stack Jackie Stack is offline
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In PA we have to code the 93000 for Medicare patients as 93005 and 93010. I don't know why they want it seperated out, but we do and we get paid for them. You do not have to use the TC and 26 modifiers with these codes.
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Old 03-30-2009, 04:29 PM
rryder1963 rryder1963 is offline
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Default Medicare EKG

For EKGs (in Washington) there is a LCD to for EKGs. There must be a specific dx or symptom as to why the EGK is being done considered medically necessary from the LCD for reimbursement. Pre-op EKGs are never paid for if that is the only reason it is being done.
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Old 03-31-2009, 06:02 AM
dclark7 dclark7 is offline
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In CT there is an LCD for EKG's. You can go to your carriers website and look up the LCD, it will give you the covered diagnoses. V72.81 was a covered dx until 8/08 now it is not covered. Like any procedure there must be a medically necessary reason to do the EKG. If you're having trouble with another carrier, try their website. Most carriers have sections that list what procedures are covered and the rationale.
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Old 04-01-2009, 04:24 PM
uncapooh uncapooh is offline
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Talking Ekg and medicare

Thank you all so much for your replies!!!! You gave me some good options to check out.:d
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