RABBIT2020
Networker
There see to be an invisible line between coding for a cpt and what qualifies for an independent interpretation.
the definition for independent interpretation of a test states - “The interpretation of a test for which there is a CPT code, and an interpretation or report is customary. This does not apply when the physician or other qualified health care professional who reports the E/M service is reporting or has previously reported the test." It further states "A form of interpretation should be documented but need not conform to the usual standards of a complete report for the test"
In an outpatient setting, the provider orders the EKG. There is usually no word, phrase, statement nor sentence in the provider note of the outcome/finding of the EKG. Often, there is not even a documented review of the EKG. The ordering provider takes the credit for the service as either a cpt code or to drive up data as is best for the value of the total service.
Is this how it should be?
With the 1995 guidelines, coders were encouraged to consider an EKG tracing with a provider signature and the words "agreed" stamped on the tracing -as sufficient to code for the CPT 93010.
with the 2023 guidelines an EKG tracing with the provider signature and the words 'agreed" stamped on the tracing - is sufficient to be considered as an independent interpretation.
the definition for independent interpretation of a test states - “The interpretation of a test for which there is a CPT code, and an interpretation or report is customary. This does not apply when the physician or other qualified health care professional who reports the E/M service is reporting or has previously reported the test." It further states "A form of interpretation should be documented but need not conform to the usual standards of a complete report for the test"
In an outpatient setting, the provider orders the EKG. There is usually no word, phrase, statement nor sentence in the provider note of the outcome/finding of the EKG. Often, there is not even a documented review of the EKG. The ordering provider takes the credit for the service as either a cpt code or to drive up data as is best for the value of the total service.
Is this how it should be?
With the 1995 guidelines, coders were encouraged to consider an EKG tracing with a provider signature and the words "agreed" stamped on the tracing -as sufficient to code for the CPT 93010.
with the 2023 guidelines an EKG tracing with the provider signature and the words 'agreed" stamped on the tracing - is sufficient to be considered as an independent interpretation.
