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.
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