Pediatric Coding Alert

Your 93000 pay could depend on using this tool. For insurers that follow Correct Coding Initiative (CCI) guidelines, start using modifier 59 on same-day electrocardiogram (ECG) and unrelated procedure claims, like wart and impacted cerumen removal -- or lose your $21* diagnostic charge. *Code 93000 has 0.58 relative value units or pays approximately $21 using the 2009 Medicare Physician Fee Schedule, which you can use to judge private payers' rates. Since April, Medicare has denied ECG code 93000 on three claims that also involved a procedure, reports Sherry Morshedi, RHIT, practice manager for Benny J. Green, MD, PA, in Little Rock, Ark. "Medicare advised me to use modifier 59 on the ECG." Understand Medicare's Extended Surgical Package CMS has expanded its global surgical package inclusions. To close a loophole that may have allowed physicians to report a routine pre-surgery ECG separately from a procedure, CCI 15.1, effective April 1, placed a [...]