Results 1 to 5 of 5

EKG Question

  1. #1
    Default EKG Question
    Medical Coding Books
    Let's say a patient comes into the ED with chest pain. An EKG is performed, and it's determined that the patient needs to have cardiac catheterization done that same day. Can the ED charge for the EKG, or is it a component of the cardiac cath done on the cardiology floor? If it is separate, how can this be billed?

    Thanks for your help!

  2. #2
    Default
    Quote Originally Posted by tfrick2 View Post
    Let's say a patient comes into the ED with chest pain. An EKG is performed, and it's determined that the patient needs to have cardiac catheterization done that same day. Can the ED charge for the EKG, or is it a component of the cardiac cath done on the cardiology floor? If it is separate, how can this be billed?

    Thanks for your help!
    I'd say bill it. This is EKG isn't being done during the cardiac cath. The EKG was done at a separate session from the cath.

    Either code 93000, 93005, or 93010.

    Jessica CPC, CCC

  3. #3
    Default
    Quote Originally Posted by Jess1125 View Post
    I'd say bill it. This is EKG isn't being done during the cardiac cath. The EKG was done at a separate session from the cath.

    Either code 93000, 93005, or 93010.

    Jessica CPC, CCC

    That's been my understanding, but a coworker received guidance that states, "The EKG was performed as a diagnostic service that then resulted in a heart catheterization being performed. Therefore, the EKG would be considered inherent with the heart cath and not separately reported."

    This sounds wrong to me, but my coworker also feels that, in light of the above guidance, using the -59 modifier on the EKG would be incorrect because the EKG and heart cath are being done on the same organ system/site.

  4. #4
    Location
    Kansas City, MO
    Posts
    92
    Default
    Whom did your coworker receive this guidance from?

    APCs Weekly Monitor recently released an article addressing this issue...it states:
    "If documentation substantiates that an EKG was performed as a diagnostic test (signs/symptoms or other indication) either before or after a cardiac catheterization procedure, append modifier -59. However, an EKG performed as a baseline screening or to be certain that everything is ok after a procedure, is not a diagnostic test and should not be reported with the modifier."

    If this was a denial I would definitely appeal.

  5. #5
    Default
    Quote Originally Posted by PRICEOR View Post
    Whom did your coworker receive this guidance from?

    APCs Weekly Monitor recently released an article addressing this issue...it states:
    "If documentation substantiates that an EKG was performed as a diagnostic test (signs/symptoms or other indication) either before or after a cardiac catheterization procedure, append modifier -59. However, an EKG performed as a baseline screening or to be certain that everything is ok after a procedure, is not a diagnostic test and should not be reported with the modifier."

    If this was a denial I would definitely appeal.

    Information was received from the AHA (American Hospital Association). I just found the same article you're referencing. I will definitely forward that to her as well. Thank you!

Similar Threads

  1. Reason for EKG vs results of EKG
    By tag60 in forum Diagnosis Coding
    Replies: 0
    Last Post: 11-08-2015, 10:42 PM
  2. Office EKG question?
    By jlb102780 in forum Cardiology
    Replies: 1
    Last Post: 04-25-2014, 11:12 AM
  3. EKG Interp Billable Provider Question
    By Keri-Harris in forum Cardiology
    Replies: 0
    Last Post: 05-31-2012, 08:58 AM
  4. EKG Billing Question
    By tfrick2 in forum Emergency Department
    Replies: 0
    Last Post: 05-05-2011, 08:31 AM
  5. ekg question
    By amb1974 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 08-18-2009, 11:56 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.