# Need a separate report for 93000, 93005 and 93010



## Gainingknowledgedaily (Oct 30, 2013)

Our providers include a small statement of their findings in thier ED note or progress of the EKG for example

EKG interpretation:
Time reviewed:
Symptoms at of EKG:
Rhythm
Rate:
Axis:
Ectopic:
Conduction:
ST Segments/Waves
TWaves:
Comparison to prior:
And Clinical impression:
However I read material that the service must have separate, identifiable, signed reports. This I read off Decision Health Answers, I cannot find anything on CMS, plus this does statement alone does not tell me how many leads they use and even if they did I still wonder if they still need the separate report. Can anyone confirm and know of any other resource their preferable from CMS or NGS that states this. Help is appreciated. Thank you.


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## gjja (Nov 19, 2013)

So glad you posted this because I recently started Cardiology coding and I was questioning the same thing.  Unfortunately, I have not found a definitive answer either. It seems to be accepted practice, from what I can see, to be entered in the progress note; but the CPT code definition specifically states separate and identifiable report and signature. Will post additional information if I find it. Thanks for the post.


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## HEMINGWAYT (Dec 2, 2013)

There should be a separate EKG report that prints off your EKG machine.  The physician should interpret the test and sign off on the report.  You should be able to tell the # of leads from the report also.  Make sure if you are billing for the interpretation of the EKG report that your physician has actually been the one who did it and signed the EKG.  If your physician is reviewing an EKG interpreted by another phyician he may not bill for it even if he documents it.


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## napahny@aol.com (Feb 4, 2014)

*EKG report*

EKG's Rule per CMS

EKGs

? Document the interpretation of the tracing in a separate section of the ED chart.

? For EKGs, the interpretation must include appropriate comments on any 3 of the following 6 elements: (1) the rhythm or rate (2) axis, (3)intervals, (4) segments, (5) notation of a comparison with a prior EKG if one was available to the ED physician, and (6) summary of clinical condition.

"An EKG with interpretation must have the full graphic tracings with formal written or printed interpretation on file for review. The interpretation should appear on the designated sections of a page formatted EKG or written in the clinical records. Interpretations should include appropriate comments on rhythm, axis intervals, acute or chronic changes and a comparison with the most recent tracing. While every single parameter is not required for each tracing, the appropriate measurements must be mentioned if the purpose of repeated EKGs is to monitor the effects of a given parameter, e.g., the QT interval.
Medicare*CAC, June 1995

For example:

- EKG reveals normal sinus rhythm, no axis deviation, no acute changes.

- EKG reveals normal axis and intervals, no previous EKG for comparison.

- EKG reveals atrial fibrillation, rapid ventricular response, non-specific ST-T wave changes

- EKG reveals normal sinus rhythm, normal axis, T-wave inversion in V3 and V4 and T-wave flattening and high laterally. No EKG was available for comparison.

- EKG reveals normal sinus rhythm with rate of 66, PR and QRS intervals within normal limits, some QRS complexes in lead III and T-wave abnormalities in I and aVL, but when compared to prior EKG there is no acute change noted.

RHYTHM STRIPS

Rhythm strip interpretations cannot be billed when they are done at the same time as a full EKG. However, they can be billed when performed at a time different than the EKG and when the medical necessity of the rhythm strip is clear. When clearly necessary, each may be billed separately. Documented change in a patient?s condition or response to medication would allow separate reporting of a rhythm strip after an EKG was done.
__________________
Found this on webpage , hope it's current


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