EKG - 93005 vs 93000 vs 93010

mkm1517

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I'm looking for input regarding coding EKGs. This is what I understand the codes to mean:
- 93005 = EKG tracing only / no interpretation.
- 93000 = EKG tracing with interpretation & report documented on same day as the EKG was taken.
- 93010 = EKG tracing with interpretation & report documented on a different day as the EKG was taken.

I suppose my main question is what constitutes an interpretatin & report? My docs will say "normal EKG, no ST-wave changes" and this is documented in the patient's EMR in the doc's progress note. Does this constitute appropriate documentation to support coding 93000 or 93010 (depending on timing)? I understand "normal EKG" or "abnormal EKG" is not sufficient documentation.

Second part of my question: In our office the patient has an EKG done and then the doc will interpret the reading (on the same day the EKG was taken) and then send the EKG to a different facility for the official full-written report. Can we code 93000 or 93010 (again depending on timing) or should we just be coding the 93005 for the tracing?

Your help is greatly appreciated! Thanks much!
 

arleneg527

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Usually for an EKG, we code 93510,93543,93545,93555,93556, depending on what is done (LV angiogram). Also if it is done in a hospital the Dr. portion needs a modifier 26 for 93510,93555 and 93556.

Arlene
 

mkm1517

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I'm asking for codes for an EKG only. We are a family practice and so we don't perform angio's or anything.:confused:
 

arleneg527

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Sorry MKM

the code for the EKG is 93307,93320,93325, I don't know why I was thinking of left heart cath.

Sorry.
 

mkm1517

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I'm confused...So when are the codes in my initial post used?
 

RGALVEZ

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93000

You are using the correct code of 93000, 93005 and 93010 if you are doing an "ELECTROcardiogram", also known as EKG. If you are doing this in your office with your machine and your Dr. is reading it, then you bill 93000 ( up to 12 leads). I believe that he is sending it out for the "formal" report to whomever is doing his dictations, as we did. The 93307 is for an ECHOcardiogram. You would bill the 93010 when the pt had the EKG done at the hospital or the machine used is not "owned" by the Dr. Some carriers want you to append modifier 26 to indicate that the Dr. has performed only the "professional" component of the procedure. You would bill the 93005 if all he (the Dr.) did was perform the EKG w/o interpreting or generating a report. Hope this has helped some. I managed a Family Practice and we billed these codes out from time to time.
 

mkm1517

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Thank you RGALVEZ! I did look up those 933xx & 95xxx codes and saw they were for echo's (not electro's). I appreciate your input!
 

SBrown

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Is the Dx of HTN sufficient medical necessity to order a EKG?

Situation:

new patient, has a hx of HTN, physician wants an EKG - there is no complaint - just the hx of HTN and the physician thinks it is related to 'white coat syndrome'

Thoughts?

Thanks - Schawn
 
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