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EKGs getting denied?

  1. #1
    Default EKGs getting denied?
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    Is anyone having problems with EKG's being denied by Medicare? We're using 93000 with an E/M code, and double checking that we're using a ICD-9 code that shows medical necessity. We don't usually add a -25 to the office visit, but if we do add the -25 it doesn't seem to change the result.
    Does anyone have better results using 93005 and 93010 together in place of 93000? Thanks a bunch for any help.

  2. #2
    Columbia, MO
    Have you appealed any? There should not be a problem as long as you have medical necessity. Do not bill the 93005 and the 93010 instead. Also did the patient have an EKG with another provider on the same day? or even the day before? If so you probably need a 77 modifier. What does the denial code say? Is it always the same denial code?

    Debra A. Mitchell, MSPH, CPC-H

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