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.
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