Wiki Pacer interrogation with EKG and E&M visit

[grace07]

Hi we see patients in an outpatient facility. The physicians are billing office visit codes with the ekg code 93000 and pacer or icd interrogation codes all on the same day. We are receiving large denials of the ekg. I believe the ekg would be paid if we add a 59 modifier to the pacer or icd procedure code. Can anyone let me know if I am correct?

grace07

 

[deeva456]

Hi,

Yes, you are correct. You can add modifier 59 to the EKG ONLY if it was medically necessary to perform the EKG and the pacer/ ICD interrogation on the same day.

If the EKG is done and the Dr finds the tracing is abnormal and an interrogatoin is needed to check the pacemaker then he can bill for both, otherwise if he is doing it routinely then no, he should be bill for the ekg only the O.V and interrogation.

Dolores, CPC-CCC