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EKG coding ?

  1. Default EKG coding ?
    Medical Coding Books
    When I bill 93000 for EKG to Medicare they deny it reading that I need a referring provider name, etc. The doctor I work for does them all the time without needing a referring provider.
    Medicare also denied 81002 U.A. - Dip (OV) stating the same. I'm confused. Please help.

  2. Smile
    This Medlearn Matters article will help explain the referring provider issue with Medicare.
    https://www.cms.gov/MLNMattersArticl...ads/SE1011.pdf

  3. Default
    Quote Originally Posted by patbaylon View Post
    This Medlearn Matters article will help explain the referring provider issue with Medicare.
    https://www.cms.gov/MLNMattersArticl...ads/SE1011.pdf
    Why would the doctor need a referring physician if this is something he does all the time? There are no referring physicians involved. Patients come in with chest pain and he does an EKG. If he sees something of concern he will refer them out or send them to the hospital but that is not always the case. Medicare does not pay for a family physician to do and EKG in the office?

  4. #4
    Location
    Duluth, MN
    Posts
    12
    Default
    Where I work we have to split the 93000 out "For the 93000, ECG (includes interpretation and tracing) we are not able to bill the GLOBAL charge (93000) to Medicare or Medicare replacements. The charges need to be split into the read (93010) and the tracing (93005)" - however we are a provider based facility also.

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