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Answer: When coders are reporting diagnostic tests, they should remember to code based on two factors:
1. a technical component, the actual performance of the test, and
2. a professional component, the internist's interpretation of the results.
There are separate codes for ECGs: 93000 for the professional and technical components performed together; 93005 for the technical portion alone; and 93010 for interpretation and report only.
According to Emily Hill, PA-C, president of Hill and Associates in Wilmington, N.C., 93005 is for the performance of the test in the nursing home, which would be billed by the nursing home. Code 93010 would be used for the interpretation and report claimed by the internist.
However, Hill emphasizes that the internist must document that he or she actually looked at the test and made some clinical determination to justify billing for the interpretation. She says that documentation must include more than the automated printout that many ECG machines provide for a test result.
"The printout does give some indication of the result and interpretation," she says. But it alone is not an accepted form of documentation.
Hill suggests internists make a separate note indicating their review of the ECG strip, as well as clinical observations and diagnosis. Alternatively, some carrier's accept the ECG strip as acceptable documentation. Coders should check with their carriers for the exact guidelines. |
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