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Thread: Physical code

  1. #1

    Default Physical code

    AAPC: Back to School
    How would you code a well visit physical with an EKG? and what diagnosis would you use?

  2. #2
    Join Date
    Apr 2007
    Seacoast- Dover New Hampshire


    Look in the V70 series
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. #3
    Join Date
    Apr 2007
    Loma Linda,CA


    Are EKG's normally part of your physicals? Or did the physican find something that is why he is asking for the EKG, if thats the case the diagnosis for the EKG would be that symptom or diagnosis. Otherwise I agree I would use v70.* however I'm not sure if that is enough to support this service looking at it from the insurance end.

  4. #4
    Join Date
    Apr 2007

    Default Ekg

    We use EKG and the dx code 401.9 or a cardiac code, if the pt has cardiac issues or hypertension issues with a complete physicial.
    [I]Elizabeth Comma-Watson, CPC
    Billing/Coding Specialist
    Greensboro, NC 27455-2601

  5. #5
    Join Date
    Apr 2007
    Lubbock, TX


    You'd just use whatever well physical code pertains to the visit. No modifier should be needed to get the visit to pay separately from 93000. The diagnosis code depends on the reason for the EKG, as mentioned in a reply above, but just a warning - expect some difficulty getting 93000 paid with a routine diagnosis, because some payors only cover it when there's obvious medical necessity. (If you have the documentation to back it up, though, denials can be fought.) If it's something that you guys do routinely w/well visits, make sure to check patient benefits to see what their insurance covers, so they can opt out of it or sign a waiver if needed.

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