Your Be the Expert: Rhythm ECG

Test your knowledge. Determine what you would do in this situation before looking at the box below for the answer.


Question: Is it appropriate to use 93041 (rhythm ECG, one to three leads; tracing only without interpretation and report) for the use of the cardiac monitor in the ED in addition to 93005 (electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report) for the 12-lead EKG? I believe we can bill these two codes together with modifier -59 because the 12-lead is a separate procedure from the monitor.

Montana Subscriber



Answer: The Correct Coding Initiative (CCI) version 7.3 edits consider the 93005 comprehensive to 93041, and 93041 has no APC reimbursement assigned for Medicare billing. If the cardiac monitoring is a discrete procedural service, it must meet medical-necessity guidelines and be documented as a
physician order.

Although it is considered a valuable service to the ED patient (revenue center 450), according to the APC final rule, the service is billed under revenue center 730 (electrocardiograms), which includes 93005-93014 (physician review with interpretation and report only), 93040 (rhythm ECG, one to three leads; with interpretation and report), 93224 (electrocardiographic monitoring for 24 hours by continuous original ECG waveform recording and storage) and 93278 (signal-averaged electrocardiography, with or without ECG).


- Published on 2001-06-01