Cardiology Coding Alert
Watch How You Bill EKG and Rhythm Strips
Question: Can you bill electrocardiogram (EKG) and rhythm strips on the same patient? We routinely place patients on a monitor for syncopal episodes, shortness of breath and palpitations. One to two hours of monitored rhythm helps determine the diagnosis. Rhythm analysis is part of the EKG evaluation. Can you advise us on how to proceed? Tennessee Subscriber Answer: The word "routinely" is bothersome. If you "occasionally" monitor patients for such symptoms as syncope (780.2), shortness of breath (786.05) or heart palpitations (785.1), then you would append modifier -59 (Distinct procedural service). Also, if the patient has a different diagnosis to support the monitoring and rhythm strip analysis, then you would use modifier -59. If you do this routinely in the office, however, then you would only bill for the rhythm strips.
Cardiology Coding Alert
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