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Pulmonology Coding Alert

Reader Questions:

Code Condition to Show Needed ECG

Published on Sun May 27, 2007

Question: A pulmonologist ordered an electrocardiogram during a routine physical for a 53-year-old woman who has chronic emphysema. How can I show that the ECG was medically necessary and not just for routine preventive care?

Florida Subscriber Answer: The patient's pulmonary condition indicates the potential for cardiac complications, which makes monitoring her heart medically necessary. Because the pulmonologist ordered the ECG to monitor the patient's emphysema -- not just for routine preventive care -- use that ICD-9 code as the primary ECG diagnosis. It is important to monitor the heart. If the patient also has  specific symptoms (such as shortness of breath), list them as the primary reason for the testing.
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