Coding EKG interps

SDAlward

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We had a third party company bill our EKG reads done in the hospital and we have recently taken them back and there are some back and forth opinions about how to report these and I'm hoping someone can give me some clarification.

As far as the dx code to use, do we use the reason for admit/order or can we use the actual dx from the report. (e.x. patient admitted with abdominal pain (not payable) but the EKG interp says sinus tachy (payable), can I use the tachy?

Also, what DOS do we use? the date the test was done or the date the doctor read it. I noticed some say "unconfirmed" which I don't think we can bill because technically nobody read it?
 

Pam Brooks

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As far as the dx code to use, do we use the reason for admit/order or can we use the actual dx from the report. (e.x. patient admitted with abdominal pain (not payable) but the EKG interp says sinus tachy (payable), can I use the tachy?

If you are coding for the professional interpretation, (i.e. 93010) you use the diagnosis that is indicated on the physician's read. If the EKG is normal, then you code based on the order. Don't ever code just for reimbursement...code only what they provider indicates or what is on the order.

Also, what DOS do we use? the date the test was done or the date the doctor read it. I noticed some say "unconfirmed" which I don't think we can bill because technically nobody read it?

You may need to check with your Medicare contractor. Ours allows us either one. Correct billing indicates you bill for the date of the professional read, but if your payer has no preference, sometimes it's easier to code the same day as the test. And it goes without saying (I hope) that if there is no read, you cannot code it out and bill for it.
 
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