Advanced Search

Primary Care Coding Alert

Break ECG, Catheter Surgical Package Inclusions When Appropriate

Published on Mon Aug 24, 2009

Your 93000, 51701 pay hinges on employing this tool. If you missed the Correct Coding Initiative (CCI) 15.1's blanket of edits, be prepared to battle for electrocardiogram (ECG) payment. Since April, Medicare has denied ECG code 93000 on three claims that also involved a procedure, reports Sherry Morshedi, RHIT, practice manager for Benny J. Green, MD, PA, in Little Rock, Ark."Medicare advised me to use modifier 59 on the ECG." Experts walk you through using this tool to correctly unbundle an ECG (93000) or in/out cath (51701) from another procedure's surgical package. Recognize Medicare's Extended Surgical Package CMS has expanded its global surgical package inclusions. First, CCI 13.3 included catheter codes in most minor and major procedure codes. Then, to close a loophole that may have allowed physicians to report a routine pre-surgery ECG separately from a procedure, CCI 15.1 placed a blanket bundle on most surgery codes, minor and [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Primary Care Coding Alert

View All