EKG interpretation with ER visit billing question


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A patient was seen in the ER, and an ER visit 99284 was billed. An EKG was done that was ordered by the ER doctor, who reviewed it but did not do a formal interpretation. A cardiologist did an interpretation of the same tracing later on the same date. Can the cardiologist's interpretation be billed as 93010? I know if that if the ER doc had done an interpretation it would be included in the ER visit, but if a provider of a different specialty interprets it, can this be billed separately? Someone told me no. Is this because an EKG interpretation is always included in an ER visit, no matter who interprets it?
What if the patient had been seen in the ER and then later was admitted to inpatient by a hospitalist, and the EKG was not ordered in the ER but later by the hospitalist, and then interpreted by the cardiologist, all on the same date. Then could 93010 be billed by the cardiologist?

Electrocardiograms (ECG) (e.g., CPT codes 93000, 93005, 93010) will not be separately reimbursed when submitted with a cardiac stress test (CPT code 93015), a cardiac test that includes an ECG as part of the test, or with initial hospital care. A three-lead ECG is considered incidental to a 12-lead ECG. Separate reimbursement for ECGs that are considered incidental is not allowed. An ECG is considered mutually exclusive to physician services for cardiac rehabilitation (CPT code 93797).

Separate reimbursement for ECGs that are considered mutually exclusive is not allowed. Separate reimbursement for the interpretation of an ECG report (CPT code 93010) will be allowed once for the report officially attached to the EKG. Separate reimbursement is not allowed for 93010 when submitted with the following services: emergency room E/M (CPT codes 99281-99285); or critical care E/M (CPT codes 99291-99292). Interpretation of the ECG report by the attending physician is considered part of the E/M visit.