Correct DX order when dealing with Cardiac patient

Orangeburg SC
Best answers
when billing for an EKG done on a patient --
and you have dx abnormal EKG
your patient has tachycardia and also
a cardiac murmur..

what is the order of the dx codes so that the charges will get paid for the services the doctor rendered,

Thank you for your assistance

Jane Albright


Victoria, TX
Best answers
I wouldn't bill the diagnosis of abnormal EKG. Typically you only bill the abnormal findings codes in the absence of a diagnosis to explain the abnormal finding. Since you have a diagnosis of tachycardia and a cardiac murmur, those are the only two diagnosis codes I would bill.

What was the reason the patient presented for the EKG?

  • If the patient presented for an EKG because of a previous abnormal EKG, then the order of the remaining two codes doesn't matter since either could be the principle diagnosis. Most coders would code the tachycardia first and the murmur second, since the tachycardia tends to be the more serious of the two conditions.
  • If the patient presented for the EKG due to suspected cardiac murmur, then I would code the murmur first, followed by the tachycardia.
  • If the patient presented for the EKG due to suspected tachycardia, then I would code the tachycardia first, followed by the murmur.
Hope that helps!

Jennifer M. Connell, CPC, CENTC, CPCO, CPPM, CPMA, CPC-P, CPB, CPC-I