tci ED Coding & Reimbursement Alert - 2006 Issue 5

READER QUESTIONS: Choose Most Specific Dx Possible on ECG Claims

Question: What codes should we use to report diagnostic electrocardiography (ECG) tests? And how can we prove medical necessity for these tests? We have gotten several recent -medically unnecessary- denials on ECG claims.Minnesota Subscriber Answer: Physicians perform ECGs regularly, but payment for this intricate procedure depends on whether you can prove medical necessity. Coders report ECG tests with these codes:- 93000 (Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report) if the physician performed the ECG and the interpretation - 93005 (... tracing only, without interpretation and report) if the physician performs an ECG with...

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