# Multiple EKGs on the same DOS



## Partha

*Our providers in New York sometimes perform several EKGs on the same day due to patient conditions, are we supposed to bill in 1 line with multiple units or bill with modifier 59 or 76 in multiple sides. Normally how many EKGs are covered by insurance?*


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## RNCPC0709

*Modifier 76*

Modifier 76 would be appropriate (or 77 if performed by a different physician) for the additional EKG's.  
As to the "how many are covered" issue, for most carriers this is simply a medical necessity issue.  From a clinical standpoint, it is sometimes necessary to perform several EKG's on the same date of service (for instance, after a cardiac drug is given to assess the effectiveness of the intervention).  If the additional units are denied, I would appeal with the reports (make sure they list the reason the EKG was performed).
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PB


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## Partha

*RNCPC,

What about NY Medicare carrier? I said our providers are from NY.

You are saying use mod 76 and then additional units, that's contradicting??

Our providers doesnt perform multiple EKGs without medical necessity*


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## cvand1972

*multiple EKGs on same date of service*

We are in Upstate NY:
We bill a single unit/claim for each EKG.  The first EKG billed gets no modifier.  The second EKG billed gets a 76 or 77, depending on whether it was read by the same physician or a different physician.  Third gets a 76 or 77 and so on.  
So if they had 2 EKGs, then there would be 2 lines: One without a modifier and one with.  If they had 3 EKGs, then there would be 3 lines: One without a modifier and 2 with.
Everyone is paying us just fine.


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## Partha

*Great we are doing exactly the same, only that we are running into problem when we several more than 3 EKGs done on a single day...

Thanks!*


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## Pamela.Bates

*Additional question on mods*

Input please! So the scenario I'm seeing is Ekg charges 93005 with modifier 76- and then patient has a stress test. I don't feel it is appropriate to add a modifier 59 IN addition to modifier 76. Can someone direct to the guidelines that clarify? 
Thanks!


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