ED Coding and Reimbursement Alert

Question: I am unsure about some of the ECG reporting rules. Could you please explain the rhythm ECG CPT® guidelines?

Codify Subscriber

Answer: You would report rhythm electrocardiogram (ECGs), which have no more than three leads, with the following codes:

• 93040 (Rhythm ECG, 1-3 leads; with interpretation and report). This is the global code, which represents both the technical and professional components of the service.
• 93041 (...; tracing only without interpretation and report). If you perform only the technical component, of the service, you would report this code.
• 93042 (..., 1-3 leads; interpretation and report only). If you perform only the professional component of the service only, then you would report this code.

You should report 93040 through 93042 when the following criteria are met, according to CPT^®:

• There must be a specific order for the ECG or rhythm strip.
• The order for the exam must have been triggered by an event, like a sign or symptom
• The physician uses the rhythm strip to help diagnose the presence or absence of an arrhythmia.
• A separate signed, written, and retrievable report should be a component of the medical record.
• The documentation in the patient's medical record should support the medical necessity for the ECG or rhythm strip.

Don’t miss: You should not report 93040 through 93042 to indicate the review of the telemetry monitor strips taken from a monitoring system, per CPT^®. The physician’s review of the telemetry data is considered part of the E/M service, so it is not a separately reportable service.