Wiki EKGs on the same day as a procedure


Cape Coral, FL
Best answers
Good afternoon everyone,

For the following procedures can we bill for an EKG on the same day?

1) Pacemaker implant or repositioning: we were told to bill for all EKGs, correct?
With modifier -76 or -77 and a modifier -59. Correct?
Which modifier is in the first position?

2) Cardioversion: do not bill any EKGs before the procedure, however you could bill all the EKG's after the procedure. Correct?

3) Cardiac Caths: do not bill any EKG on the same day. Correct?

If you can please list your source for this information. Thank you so much!
We do not bill EKG's in your first scenario; howevver, when we implant AICD we do bill for the threshold DFT testing: 93641. I would not use -76 or -77 to get the EKG paid. If, in fact, there is medical necessity for a seperate and distinct EKG then I would attach -59.

In looking at NCCI, it appears you can bill an EKG with in all three scenarios with a -59 but the documentation will have to be solid in proving that it was a distinct and seperate service meeting medical necessity.