Advanced Search

Cardiology Coding Alert

Reader Questions:

You Can Get Paid for Inconclusive Tests

Published on Fri Oct 10, 2008

Question: When my cardiologist performs a diagnostic test (for instance, an echocardiogram) and it turns out inconclusive or negative, should I still report the diagnosis that he was attempting to rule out (such as coronary artery disease)?Virginia SubscriberAnswer: You should report the signs and symptoms the patient has. If you code them completely and carefully, you should collect reimbursement.For instance, a patient presents with complaints of chest pain and presumptive angina. The cardiologist performs a cardiac workup, which turns out negative. Further determination reveals the patient has only gastroesophageal reflex -- a diagnosis that alone doesn't medically justify the cardiac test. You should report 786.50 (Chest pain, unspecified) for the cardiac workup, not 530.81 (Esophageal reflux).
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Cardiology Coding Alert

View All