Primary Care Coding Alert

Question: Can we only bill a screening EKG with an IPPE (initial preventive physical exam), or can we bill it anytime as long as we code correctly with the G code?

Kentucky Subscriber

Answer: You can only bill for a screening EKG with G0403 (Electrocardiogram, routine ECG with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report) in conjunction with the patient's IPPE. Any other time your physician conducts an EKG, you should submit 93000 (Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report). In this latter case, you would indicate the nature of ECG (i.e. screening versus diagnostic) through an appropriate ICD-9 code.