# EKGs on the same day as a procedure



## Summer (May 9, 2012)

Good afternoon everyone,

For the following procedures can we bill for an EKG on the same day?

1)  Pacemaker implant or repositioning:  we were told to bill for all EKGs,  correct?
      With modifier -76 or -77 and a modifier -59.   Correct?
      Which modifier is in the first position?

2)  Cardioversion:  do not bill any EKGs before the procedure, however you could bill all the EKG's after the procedure.    Correct?

3)  Cardiac Caths:  do not bill any EKG on the same day.   Correct?

If you can please list your source for this information.  Thank you so much!


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## jewlz0879 (May 10, 2012)

We do not bill EKG's in your first scenario; howevver, when we implant AICD we do bill for the threshold DFT testing: 93641. I would not use -76 or -77 to get the EKG paid. If, in fact, there is medical necessity for a seperate and distinct EKG then I would attach -59. 

In looking at NCCI, it appears you can bill an EKG with in all three scenarios with a -59 but the documentation will have to be solid in proving that it was a distinct and seperate service meeting medical necessity. 

HTH


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