# Correct billing for 93010 and dos



## tlm5506

Hello.
I have tried researching this issue and I just come up with conflicting information and old information that I believe is no longer effective when it comes to billing 93010 when the interpretation is done a day or two later than when the EKG is performed.
Most of the EKGs that we bill for are done in the ER or an outpatient setting and the physicians are not reading and interpreting them until a day or two later. We have been billing them by the date that the interpretation was done by the physician and not when the EKG was actually performed. I have heard and read that this is not the correct way to bill CPT code 93010 and that it should be the date that the EKG was performed. I am really looking for some guidance on this issue because, as I stated previously, I am hearing and reading conflicting information on this subject. 
I am hoping someone can help. I just need to know if the correct DOS would be the date the EKG is performed or when the EKG is read and interpreted by the physician when that date is not the date the EKG was performed.
Thanks.


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## Pam Brooks

Based on CMS Transmittal 1823, dated October 2, 2009, and addressing change request 6375, clarification is provided regarding the billing of Place of Service Codes for professional interpretations of diagnostics and test results by the physician.  Effective *1/4/10*, the billed charge must now reflect the actual date of the interpretation (not necessarily the date of the diagnostic test).  Effective *4/9/2013*, CR7631 established that the service location at the time the physician is interpreting the results must be the POS of the testing. 


EKG Reads:  The cardiologist reads the EKG interpretations in the office that was performed in the outpatient Cardiology lab.  This is POS 22 (where the actual test was performed).  The date of service is the date of the actual interpretation, not the date of the EKG.


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## tlm5506

Thank you for a quick response, Pam.  

I am still receiving conflicting info about this, however. I am wondering if anyone else has any thoughts about it. I agree with Pam that the date of service should be the date of the interpretation.

Hopefully more people will respond.

Thanks.


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## tlm5506

Just to add fuel to the fire......here is another scenario that I see often:

patient has an EKG done when they are inpatient at the hospital and then, for some reason, the doctor does not read and interpret the EKG until after the patient is discharged. What place of service would be used in this instance?

Thanks.


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## Pam Brooks

The place of service is always the place where the test was performed, in this case, POS 21. CMS made that rule, and sometimes we have to point these rules out to the contractors to get them paid. But my post came directly from CMS, so that's what I'd recommend you use for Medicare recipients anyway. Commercial payers have other rules, but they may vary by state, so you often have to investigate those independently from the CMS guidelines.


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## MelodyJ

Thank you for posting this. What if an inpatient had an ekg, one on the 10, one on the 11 but the doctor read them both on the 12?


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## tlm5506

That is a great question, MelodyJ, and I am curious to know how to bill this also. I see a lot of this with the EKGs that I bill - patient is inpatient and had an EKG done on one date when they were still inpatient, but the EKG is interpreted on a different date AFTER the patient is discharged from the hospital. I don't understand how to bill it as place of service for inpatient when the date of service (date the interpretation was done) is not during the inpatient stay.


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## theresa.dix@tennova.com

tlm5506 said:


> That is a great question, MelodyJ, and I am curious to know how to bill this also. I see a lot of this with the EKGs that I bill - patient is inpatient and had an EKG done on one date when they were still inpatient, but the EKG is interpreted on a different date AFTER the patient is discharged from the hospital. I don't understand how to bill it as place of service for inpatient when the date of service (date the interpretation was done) is not during the inpatient stay.



Here is a little more fuel to the fire

http://ahsrcm.com/medical-billing-news/organizations-request-cms-rule-pctc-date-service/


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## cmramon

*POS billing*

What about when the cardiologist interpret a nuclear stress test or and Echo that was done at the ER? We have a controversy in my office some agree should be 22 and others 23. Please advise.

Thank you

Clara


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## dikehn

Hi, i realize this is old, from 2014 but is there any recent or information on this issue....... what is the correct way to bill and submit the cpt 93010, the dos or the day the doctor interpreted the report... please any information would be appreciated.....


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## dikehn

Pam Brooks said:


> Based on CMS Transmittal 1823, dated October 2, 2009, and addressing change request 6375, clarification is provided regarding the billing of Place of Service Codes for professional interpretations of diagnostics and test results by the physician.  Effective *1/4/10*, the billed charge must now reflect the actual date of the interpretation (not necessarily the date of the diagnostic test).  Effective *4/9/2013*, CR7631 established that the service location at the time the physician is interpreting the results must be the POS of the testing.
> 
> 
> EKG Reads:  The cardiologist reads the EKG interpretations in the office that was performed in the outpatient Cardiology lab.  This is POS 22 (where the actual test was performed).  The date of service is the date of the actual interpretation, not the date of the EKG.


Hello,,, i am still confused on all this and need definite information... all the CR listed above i have reviewed and all deal with specifically the POS, i am still questioning the change for the DOS..... the ekg is performed on one day and the Dr interprets the report on another DOS..... does the ekg now become the dos and time of the interpt the doct signed ????


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## dikehn

theresa.dix@tennova.com said:


> Here is a little more fuel to the fire
> 
> http://ahsrcm.com/medical-billing-news/organizations-request-cms-rule-pctc-date-service/


this website i can not get too


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## Lesliewillis42

Following....


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