by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
and Marge McQuade, CMSCS CHCI CPOM
Jun 13th, 2018
Q: Our clinic is owned by a hospital, but there is equipment in the clinic to do ECG/EKG’s. When the test is done here in the clinic, and the provider does the interpretation and report, is 93000 the correct code to bill? The equipment is owned by the clinic and not the provider himself.
A: Very often the additional code information is not considered, be sure to look at each aspect of the code, such as the PC/TC Indicator. 93000 is the complete procedure and includes ECG tracing with physician review, interpretation and report. Use 93005 to report the tracing only, and 93010 to report physician interpretation and written report only.
If you look at the PC/TC Indicator on CPT code 93000, it has a #4 which means this code includes the 26 and TC components. you would not bill 93000 with a modifier, as this code is a global test only code.
It also means there are other codes that describe the PC only and TC portion only of the test, such as:
93005 - tracing only, without interpretation and report. PC/TC indicator # 3 (Technical Component Only Code)
93010 - interpretation and report only. PC/TC Indicator # 2 (Professional Component Only Code).
4 = Global Test Only Codes
This indicator identifies stand-alone codes that describe selected diagnostic tests for which there are associated codes that describe (a) the professional component of the test only, and (b) the technical component of the test only. Modifiers 26 and TC cannot be used with these codes. The total RVUs for
If the doctor is a paid employee of the clinic and the clinic owns the equipment then you can bill 93000 for tracing and reading or 93005 for tracing only.
References/Resources
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.
About Marge McQuade, CMSCS CHCI CPOM
| Marge McQuade is a certified multi-specialty coder and a certified medical manager with 30 plus years experience in the medical field as an office manager and coder. She is an instructor for coding and medical office procedures and lectures on practice management and coding topics. Currently, Ms. McQuade is the Director of Education for QPro. |
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