ED Coding and Reimbursement Alert

Question: When billing for an EKG interpretation, am I correct in thinking that there must be an order, a written interpretation and three elements from rate` and rhythm, axis, interval, comparison to another EKG or overall findings. If all criteria are met, then interpretation can be billed for the physician with 93010-26?

Answer:  If your interpretation and report includes those elements, you have likely met the basic requirementsto report the service, assuming the report was prepared by your emergency physician rather than just reviewing the interpretation by another provider.

CPT^® only describes the requirement as “preparation of a separate distinctly identifiable signed written report.” Medicare states an “interpretation and report” should address the findings, relevant clinical issues, and comparative data when available. Other payers may have their own requirements, but at a minimum, you should document the reason for the ordering the test and your findings.