Primary Care Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.



Question: What diagnosis code is used when an electrocardiogram (EKG) is conducted for the purpose of checking the heart rate on a patient who is hypertensive and has had a recent medication change?

New Jersey Subscriber


Answer: In this case, an EKG is performed to evaluate hypertension, says Cynthia DeVries, RN, BSN, CPC, coding and reimbursement coordinator for Lee Physicians Group, a 140-provider, multispecialty practice in Fort Myers, Fla. Therefore, hypertension (401.X) should be linked with the EKG (93000, electrocardiogram, routine ECG with at least 12 leads; with interpretation and report). Medicare allows for these EKGs but has edits in place that deny some diagnostic tests because of overuse. EKGs are included in that edit. If this is the case, the physician may have to write a letter to demonstrate medical necessity and support his or her medical rationale for performing an EKG.