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Have another question, what documentation is needed in order to bill/code for an ekg in the er by the ER Dr?? do I need 6 or 3 checked (we have a box on our er charts says EKG(interp by me) NSR, Rate, Axis, QRS, ST/T and Intervals that some check and some don't check) and we are having a discussion on this, I had gotten a paper on this along time ago but I can not find it..please help as always it is appreciated..alice


Des Moines
Best answers
I found this. I code them in our Emergency Department. Hope this helps!

Documentation Requirements

An ECG with interpretation must have the full graphic tracings with formal written interpretation on file for review. The interpretation should appear on the designated sections of a page formatted ECG or written in the clinical records. At a minimum, interpretations should include appropriate comments on rhythm, rate, axis, acute or chronic changes, and a comparison with the most recent tracing (if available). Appropriate measurements must be mentioned if the purpose of repeated ECGs is to monitor the effects of a given parameter, e.g., the QT interval. ECGs that are electronically read must be over-read, corrected and signed.

A physician's order must be documented in the medical record requesting ECG performance.