# EKG with an interrogation



## debbierager  (Aug 6, 2009)

Hello, I need assistance. The 93000 is denying as incidental to codes 9328X for interrogations but a modifier is allowed. I was advised that a modifier 59 can be appended IF the EKG tracing was in the chart. Because I am new to cardiology, I can't find supporting guidelines that state this is ok from a coding perspective, is the EKG separately reportable? I want to ensure that the practice is reimbursed for their servies (it's an office setting and we own the equipement) and I'm not unbundling. Any assistance would be appreciated. Thank you.


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## lindseyj (Aug 6, 2009)

We bill for an EKG, interrogation, and an office visit all on the same day. We use the 59 modifer on the EKG.


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## debbierager  (Aug 6, 2009)

Thanks Lindsay, but why? What makes the EKG distinct from the interrogation if the codes are built to be incidental? This is what I am thinking about and need further explanation. Is this written in the coding guidelines anywhere?


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## laurap (Aug 6, 2009)

My understanding is that you can only append a modifier 59 to the EKG if the EKG was done before the interrogation and due to the EKG results the doc decided to do the interrogation. Also, these circumstances would have to be documented in the patients chart. I hope this helps.

Laura L. Porter, CPC
Jamestown Area Medical Associates


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## deeva456 (Aug 7, 2009)

lauarp is correct about billing for the EKG and interrogation.  I recently read an article about this subject. I have been doing some much research and reading lately I cant remember which website I found it at. When I find the link I will post it. 

Dolores,


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## mmiciano (Aug 8, 2009)

*EKG + interrogation*

You can bill both if: 1. the EKG is done before the interrogation and the EKG result is the deciding factor of the interrogation. 2.  the patient is due for a device interrogation but also has condition that requires an EKG.  The condition should not be related to the medical reason of the device implantation.  Either way you have to have a good documentation.  I agree with the others, the correct modifier to use is 59 to the EKG.  The frequency, however, of doing the EKG and the interrogation at the same day should be carefully watched.


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## debbierager  (Aug 12, 2009)

*Thanks Delores*

Hi all, thanks for your input! Delores, I am awaiting your posting of the link with the supporting documentation! I really appreciate this!


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## deeva456 (Aug 13, 2009)

I found the article!  took a few days but I knew I had read this info.

go to: cardiologycoder. com
click on: Earn free CEU's
click on June 2009 Proficiency test - Electrophysiology Studies.  PDF publication

Jim Collins - who contributed and wrote the CCC exam answers this question about billing an EKG and interrogation on the same day. 

Dolores, CPC - CCC


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