Wiki Counting EKG towards E&M on same date

[JJOHN0312]

When auditing physicians E&M, do we count an EKG (or any other service separately reimbursed) towards an E&M on the same date of service? I have a trailblazer audit form that says not to use/count if separately reported for reimbursement? I was told, since this is in a different area than MO., we shouldn't use this form for auditing.

I don't agree because if they are already getting paid for this service, why would we count that towards their E&M service for higher reimbursement. Any input/references would be appreciated.

Thanks,

Josie

 

[OCD_coder]

Novitas follows the same methodology per their website.

It is a form of double dipping in Medicare's eyes. If you are getting reimbursed for the professional component you cannot get 2 pts for interpreting the films, strip, sample.