Primary Care Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Our family practice provides electrocardiograms (ECGs), which the family physician (FP) interprets and sends to an internist who issues a written report. How should I report the FP's services? Texas Subscriber

Answer: CPT designates three codes for ECGs. Each code reflects a different level of physician involvement. You should assign these codes based on who bears the cost of the ECG equipment and the physician's role in interpreting and reporting the study's findings. When your FP performs all of these services he or she owns or leases the equipment, interprets the results, and issues a written report you should report the global ECG code 93000 (Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report). But when the physician provides only a part of these services, you should report the appropriate component code. For instance, if the FP owns or leases the equipment and uses it to provide the tracing, but does not issue a report of his or her findings, you should assign only the technical component (93005, tracing only, without interpretation and report). But if the practice sends the patient to the hospital for the study, you should not bill 93005. If the hospital performs the study, a hospital physician, such as a cardiologist, rather than your FP, will probably read the tracing and issue a report. So you should not bill for any ECG work. If the practice does not have the equipment and the FP is the only physician to interpret the tracings and issue a report of his or her findings, you should use 93010 ( interpretation and report only). Note that 93000 and 93010 include interpretation and report. Performing only the interpretation, as in your example, does not qualify for coding the professional component. So, if another physician, such as an internist, reads your FP's tracings, you should assign 93005 to indicate that your practice provided the technical component, but the physician did not issue the written report.