Wiki EKG 93000 vs 93010

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kbarron

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I need to find in writing this: If you own the practice and machinary, you use 93000. If the hospital owns the machinary you charge 93010, the professional component and the hospital bills for the technical component. Any links would be greatly appreciated. :)
 
Ekg

This is my understanding of the way this breaks down in CPT.

If the EKG is done in an office where the Dr. owns the equipment (EKG machine) and is doing the interpretation and report use 93000. This is the global code per CPT -- ECG with at least 12 leads with interpretation and report.
If the EKG is done in a facility that owns the equipment they do 93005-TC. They own the equipment, but the Dr. does the interpretation, not the facility and he can charge 93010-26 for the interpretation and report only.

So, either 93000 (Dr owns and does it all)
93005-TC facility charge for running the test and 93010-26 Dr. charge for interpretation.

Anyone else?
 
Hello!
93010 does not need a modifer 26, it is for interpetation and report only, so 26 is not need.:)
 
Actually, if you look at the Medicare fee schedule (where they list codes with the global, the technical and professional separately on separate lines/separate RVUs) you will find only one listing for each 93005 and 93010. Neither of these needs a modifier as the verbiage clearly indicates 93005 is technical part only and 93010 is professional part only, while 93000 is the global.
 
ekg

Thanks for all of the input. I have a hospitalist that now tells me that he gives me a charge even when he reads another physicians ordered ekg.

Example: pt admit from ER, Er phys ordered EKG, when the patient comes to the floor, Hospitalist also reads that same EKG, will he get a interpretation charge also?
 
ms j

I was confused with the 93010 and 93005. I had a provider who used both codes. I sent question to PASBA and this was the response from PASBA: Answer: The provider can not use both codes on the same visit or for same patient if he is doing all the components. He should be coding it as 93000. For the 93005 means one provider does the tracing only, than when it is sent for someone else to interpretate they would code the 93010.
The providers were using 93000, then one day they all switched and started using 93005. the providers say they are not interpreting the EKG's on the same day. So, if this is the case what is the correct code for a outpatient hospital?

How come there are no guidelines strickly for cardiology? For this specialty you should have guidelines for this and able to find more examples.
 
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