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.