-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Repeat EKG- tech. error
- Thread starter Sarah Ann
- Start date
CBLENNIE
Networker
IMO you should not bill for both EKGs if the repeat procedure was done due to technician error. Neither the insurance company nor the patient should be financially liable for a service that was only rendered due to the technician's error. How would you feel if you were the patient and were expected to pay for a 2nd EKG that only had to be performed due to the error?
lgardner
Expert
I agree.
I would not bill the initial EKG that was 'bungled' by the technician.
I would not bill the initial EKG that was 'bungled' by the technician.
RABBIT2020
Networker
- Messages
- 82
- Best answers
- 0
As a coder I am ethically obliged not to code for two ekg when there is only one order. However, it has been pointed out by the department supervisor that "when you see two EKG in the chart please code for two ekg". Of course, there is no medical necessity for the second; neither is there a reason why there are two tracing in the chart. Tthe justification is that each reflects a different time and therefore they are acceptable. For me coding guidelines, medical necessity and ethical practices cannot be upheld in a revenue driven environment.
TThivierge
True Blue
Hi Sarah,
You are correct. But also if 2 claims sent the coder may have to view the results then put a claim note to tell why it should not be billed. Also when it is sent to the payer; they may reject it or ask for medical records to support the 2 EKG services billed. Also maybe your department supervisor, her superior has been told to bill 2 CPT same thing despite discrepancies to show errors made by EKG techs. Later EMR and or fiscal reports would show this if a denial mode due to errors made in the EKG department. Management may have told the supervisor to do this but she should explain to you better. They should let you put a comment on claim explaining the error of EKG lead problem so once it gets in the billing bucket to the payer ...it will be kicked out or edit stop it.
Well hope this info helps explain the workflow rationale
Lady T
You are correct. But also if 2 claims sent the coder may have to view the results then put a claim note to tell why it should not be billed. Also when it is sent to the payer; they may reject it or ask for medical records to support the 2 EKG services billed. Also maybe your department supervisor, her superior has been told to bill 2 CPT same thing despite discrepancies to show errors made by EKG techs. Later EMR and or fiscal reports would show this if a denial mode due to errors made in the EKG department. Management may have told the supervisor to do this but she should explain to you better. They should let you put a comment on claim explaining the error of EKG lead problem so once it gets in the billing bucket to the payer ...it will be kicked out or edit stop it.
Well hope this info helps explain the workflow rationale
Lady T