EKG coding

I am having trouble getting medicare to pay for an EKG during the preventive exam (G0438). I am attaching the code (93000) to an appropriate dx (ie: 401.1) but they deny as "not covered when performed during the same session/date as a previously processed service". This only began as of june or july this year. Do I need to use a modifier? (if so which one -25 or 59?).

re: EKG coding

Use a 25 modifier on the G0438. I'm pretty sure I remember reading that the 25 modifier is appropriate on the Wellness codes.

Becky, CPC

re: EKG coding

I believe the problem is with your code for the EKG. It should be G0403 when used with the 'Welcome to Medicare Visit" G0402

re: EKG coding

G0402 and G0403 is correct. No modifier needed.

re: EKG coding

I use modifier 59 on my EKG's (code G0403) with dx code V70.0 and I have no trouble getting paid.