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Thread: Multiple EKGs on the same DOS

  1. #1

    Default Multiple EKGs on the same DOS

    AAPC: Back to School
    Our providers in New York sometimes perform several EKGs on the same day due to patient conditions, are we supposed to bill in 1 line with multiple units or bill with modifier 59 or 76 in multiple sides. Normally how many EKGs are covered by insurance?

  2. #2
    Join Date
    Apr 2007
    High Point

    Default Modifier 76

    Modifier 76 would be appropriate (or 77 if performed by a different physician) for the additional EKG's.
    As to the "how many are covered" issue, for most carriers this is simply a medical necessity issue. From a clinical standpoint, it is sometimes necessary to perform several EKG's on the same date of service (for instance, after a cardiac drug is given to assess the effectiveness of the intervention). If the additional units are denied, I would appeal with the reports (make sure they list the reason the EKG was performed).

  3. #3



    What about NY Medicare carrier? I said our providers are from NY.

    You are saying use mod 76 and then additional units, that's contradicting??

    Our providers doesnt perform multiple EKGs without medical necessity

  4. #4

    Default multiple EKGs on same date of service

    We are in Upstate NY:
    We bill a single unit/claim for each EKG. The first EKG billed gets no modifier. The second EKG billed gets a 76 or 77, depending on whether it was read by the same physician or a different physician. Third gets a 76 or 77 and so on.
    So if they had 2 EKGs, then there would be 2 lines: One without a modifier and one with. If they had 3 EKGs, then there would be 3 lines: One without a modifier and 2 with.
    Everyone is paying us just fine.

  5. #5


    Great we are doing exactly the same, only that we are running into problem when we several more than 3 EKGs done on a single day...


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