EKGs on the same day as a procedure

[Summer]

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!

 

[jewlz0879]

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.

HTH