Wiki ekg frequency rule?

[sky]

is there a limit to how many ekgs can be done on a patient thru out the year? there is a dr in our practice that does an ekg on every patient that comes in & everytime that same patient comes in. is there any documentation stating that there is a limit? i realize that a cardiologist can order the ekg & use chest pain for the reason even if the patient is not having chest pain at the time of the visit or has had any chest pain since his last visit. we have a billing svc so we don't see the eob's to find out if the ekg is being denied & written off. thanx

 

[LouiseR1]

There really isnt a frequency rule, and the guideline we use is through our Medicare contractor. The general rule of thumb, is not to code every single ekg if that is your practice's protocol to do an EKG on every patient. Rather, if there is a stated reason, or if the reason would be clear to an auditor, then it can be coded. For example, if patient is coming in c/o palpitations and an EKG is done, then I would bill it However if patient is coming in for follow up to diagnostic testing and there is no clear reason why the EKG was done then I would not bill it. Look to your Medicare contractor's LCD for further guidance. Hope this helps.