Cardiology Question for the Week of October 10, 2016

Cardiology Compliance Question of the Week

Question:

Do you know if performing an electrocardiogram (ECG) prior to a heart catheterization, cardioversion, or TEE (transesophageal echocardiogram) is included in the charge? Or can we bill it separately?

Answer:

If it is a diagnostic ECG that is separately ordered and medically necessary, it may be assigned with modifier -59. If it is routine monitoring, then it would not be separately coded.

For more guidelines about this, check chapter 11 of the NCCI Policy Manual for Medicare Services, numbers 4, 15, and 16. This manual can be found under the Downloads section at https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html. Be sure to check the version that took effect on January 1, 2016.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.