EKG Question

tfrick2

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Let's say a patient comes into the ED with chest pain. An EKG is performed, and it's determined that the patient needs to have cardiac catheterization done that same day. Can the ED charge for the EKG, or is it a component of the cardiac cath done on the cardiology floor? If it is separate, how can this be billed?

Thanks for your help!
 

Jess1125

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Let's say a patient comes into the ED with chest pain. An EKG is performed, and it's determined that the patient needs to have cardiac catheterization done that same day. Can the ED charge for the EKG, or is it a component of the cardiac cath done on the cardiology floor? If it is separate, how can this be billed?

Thanks for your help!
I'd say bill it. This is EKG isn't being done during the cardiac cath. The EKG was done at a separate session from the cath.

Either code 93000, 93005, or 93010.

Jessica CPC, CCC
 

tfrick2

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I'd say bill it. This is EKG isn't being done during the cardiac cath. The EKG was done at a separate session from the cath.

Either code 93000, 93005, or 93010.

Jessica CPC, CCC

That's been my understanding, but a coworker received guidance that states, "The EKG was performed as a diagnostic service that then resulted in a heart catheterization being performed. Therefore, the EKG would be considered inherent with the heart cath and not separately reported."

This sounds wrong to me, but my coworker also feels that, in light of the above guidance, using the -59 modifier on the EKG would be incorrect because the EKG and heart cath are being done on the same organ system/site.
 

OliviaPrice

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Whom did your coworker receive this guidance from?

APCs Weekly Monitor recently released an article addressing this issue...it states:
"If documentation substantiates that an EKG was performed as a diagnostic test (signs/symptoms or other indication) either before or after a cardiac catheterization procedure, append modifier -59. However, an EKG performed as a baseline screening or to be certain that everything is ok after a procedure, is not a diagnostic test and should not be reported with the modifier."

If this was a denial I would definitely appeal.
 

tfrick2

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Whom did your coworker receive this guidance from?

APCs Weekly Monitor recently released an article addressing this issue...it states:
"If documentation substantiates that an EKG was performed as a diagnostic test (signs/symptoms or other indication) either before or after a cardiac catheterization procedure, append modifier -59. However, an EKG performed as a baseline screening or to be certain that everything is ok after a procedure, is not a diagnostic test and should not be reported with the modifier."

If this was a denial I would definitely appeal.

Information was received from the AHA (American Hospital Association). I just found the same article you're referencing. I will definitely forward that to her as well. Thank you!
 
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