Wiki Counting EKG interpretation in data

[KimWhiley]

We are a 25 bed critical access hospital. We have just recently started billing the EKG interpretations when done by our providers. They are not sent out to a cardiologist. If we are charging for the provider's interpretation 93010, can we also count it as Category 2: Independent interpretation of tests in the amount and complexity of data section? I heard on a webinar that we cannot and have also read it but if a cardiologist is not doing an overread where they would also bill for interpretation, it does not quite make sense that we could not then count the interpretation even though we are billing for it.

 

[AmandaBriggs]

If you are billing for the EKG interpretation, you cannot also use it to determine MDM. Per the AMA 2024 E/M Guidelines: The ordering and actual performance and/or interpretation of diagnostic tests/studies during a patient encounter are not included in determining the levels of E/M services when the professional interpretation of those tests/studies is reported separately by the physician or other qualified health care professional reporting the E/M service. https://www.ama-assn.org/system/files/2023-e-m-descriptors-guidelines.pdf

 

[KimWhiley]

If you are billing for the EKG interpretation, you cannot also use it to determine MDM. Per the AMA 2024 E/M Guidelines: The ordering and actual performance and/or interpretation of diagnostic tests/studies during a patient encounter are not included in determining the levels of E/M services when the professional interpretation of those tests/studies is reported separately by the physician or other qualified health care professional reporting the E/M service. https://www.ama-assn.org/system/files/2023-e-m-descriptors-guidelines.pdf

Thank you very much for your help