place of service for ekg paging thomas 7331

heartyoga

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Hi everyone,

I have a question on place of service for ekgs performed in the Er and admitted subsequently. The EKG reports states the location as Admit In Rm 420. However, when i queried and looked at the sequence of time (have to open patient chart in hospital system), it seems like the place the actual EKG was done was in the ER.

We have around a thousand EKGs interpreted in our practice per month. Does our coder have to open every chart to double check if the EKGs were done in the ER or would the location on the report Admit In (inpatient location) suffice ?

There is no difference in payment between ER and IP location. Just a technical detail on where the actual EKG was done.

The cost of opening the charts would take up the coder's time and create back log. Is the report location defensible ? Also does insurances audit the EKGs location/codes?


Thanks.
 

thomas7331

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To be honest, I don't think it will make any difference. As you've said correctly, the payment for the interpretation of the EKG will be the same for either ER or inpatient place of service. Payers will not likely recover a payment to you if the place of service is incorrect if they know that you would just resubmit the claim with the corrected place of service and get the same exact payment back again. (Payers to not want their auditors wasting time on unproductive activities any more than physicians or hospitals do.) In addition, since the place of service changes when the patient is admitted to inpatient status, it is not necessarily dependent on the actual location of the patient within the hospital. You would need to look at the time of the admitting provider's order to know exactly when the status changed from ER to inpatient. As you've pointed out, the cost in time of chasing all this information and validating will very likely to exceed your reimbursement. I would refer this to a manager and/or put it on my list of items that should be addressed and corrected for quality purposes but which are not high priority since they do not have a significant clinical or financial impact.
 

heart123

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the usual is to follow whatever the hospital codes
even though they came in thru the er and had the ekg there
once its coded IP you would then make your place of service IP
hope this helps
 
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