Q/A: Coding for ECG/EKG’s

June 13th, 2018 - Chris Woolstenhulme QCC, CMCS, CPC, CMRS & Marge McQuade
Categories:   CPT® Coding  
0 Votes - Sign in to vote or comment.

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 global procedure only codes include values for physician work, practice expense, and malpractice expense. The total RVUs for global procedure only codes equals the sum of the total RVUs for the professional and technical components only codes combined.

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.


Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.

Latest articles:  (any category)

Where is the CCI Edit with Modifier 25 on E/M?
May 20th, 2020 - Christine Woolstenhulme, QCC, CMCS, CPC, CMRS
If you are not seeing a CCI edit when reporting an E/M code with a certain procedure, it may be that there is no edit. CMS does not have a CCI edit for every CPT code, however, there are still general coding rules that must be followed.  The use of Modifier 25 is one example ...
Packaging and Units for Billing Drugs
May 18th, 2020 - Christine Woolstenhulme, QCC, CMCS, CPC, CMRS
To determine the dosage, size, doses per package and how many billing units are in each package, refer to the NDC number. Take a look at the following J1071 - Injection, testosterone cypionate, 1mg For example; using NCD # 0009-0085-10 there are 10 doses of 100 mL (100 mg/mL = 1 mL and there are ...
Getting Your Practice Back on Track
May 12th, 2020 - Wyn Staheli, Director of Research
As we begin returning back to work, we will all face a new normal. The COVID-19 pandemic has changed the face of business. While it has certainly been a challenge to keep up with the ever-changing regulations (that’s likely to continue for a little longer), exciting new opportunities have also been created, such as the expansion of telemedicine. There’s also the maze of government funding that needs to be navigated and an increased awareness of OSHA standards to implement.
ICD-10-CM - Supplement information for E-Cigarette/Vaping Reporting
May 5th, 2020 - Christine Woolstenhulme, QCC, CMCS, CPC, CMRS
The CDC has released additional information and coding guidance for reporting encounters related to the 2019 health care encounters and deaths related to e-cigarette, or vaping, product use associated lung injury (EVALI).  The update offers coding scenarios for general guidance, poisoning and toxicity, substance abuse and signs and symptoms.  ICD-10-CM Official Coding Guidelines - ...
Additional Telehealth Changes Announced by CMS
May 4th, 2020 - Wyn Staheli, Director of Research
On April 30, 2020, CMS announced additional sweeping changes to meet the challenges of providing adequate healthcare during this pandemic. These changes expand the March 31st changes. The article covers some of the key changes. See the official announcement in the references below.
Effective Risk Adjustment Requires Accurate Calculations
April 27th, 2020 - Wyn Staheli, Director of Research
Risk adjustment is simply a way of making sure that there are sufficient funds to adequately take care of the healthcare needs of a certain population. It’s a predictive modeling methodology based on the diagnoses of the individuals in that population. As payers move to value based models, they heavily rely on risk adjustment to ensure proper funding.
COVID-19 Clinical Trial Participation Helps Providers Earn MIPS Credit
April 22nd, 2020 - Wyn Staheli, Director of Research
All healthcare providers who are currently participating in the MIPS portion of Medicare’s Quality Payment Program may want to participate in the new COVID-19 Clinical Trials improvement activity. Read more about it here.

Home About Contact Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2020 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association