Cardiology Coding Alert

Question: My cardiologist performed both the professional and technical components of a patient’s one-lead rhythm electrocardiogram (EKG). My cardiologist’s order for the EKG supported the diagnosis of unspecified chest pain as the triggering event. My cardiologist used the rhythm strip to help diagnose the presence of absence of the arrhythmia. The medical documentation demonstrated the need for my cardiologist to evaluate the patience presence or absence of an arrhythmia. My cardiologist’s separate signed, written, and retrievable report followed his EKG order. My cardiologist owns both the EKG machine and the supplies. Which CPT^® and ICD-10-CM codes should I report on my claim?

California Subscriber

Answer: You should report 93040 (Rhythm ECG, 1-3 leads; with interpretation and report). You would report R07.9 (Chest pain, unspecified) as the ICD-10-CM code.

When you report rhythm EKG code 93040, you must be able to answer the following questions with “yes.”

• Was there a specific order for the EKG or rhythm strip?
• Was the order for the exam triggered by an event, such as a sign or symptom?
• Did your physician use the rhythm strip to help diagnose the presence or absence of an arrhythmia?
• Did the physician’s separate signed, written, and retrievable report follow the EKG order?
• Did the documentation in the patient’s medical record support the medical necessity for the EKG or rhythm strip?

Editor’s note: You can review the MPFS proposals at https://s3.amazonaws.com/public-inspection.federalregister.gov/2020-17127.pdf.