Wiki EKG & Pacer checks same day

[mcclurech@cox.net]

Our cardiologists are performing both a pacermaker check and EKG same day. I am finding conflicting information on if this is appropriate. I realize that both tests are checking for the heart rythm.

It was my understanding that you could bill for both if the patient had an abnormal EKG then you could do the pacer check?

If so can you point me in the direction of coding literature that I can show to my physicians?

Thank you for your assistance.

 

[jewlz0879]

The National Correct Coding Initiative (NCCI) includes edits that preclude billing an EKG at the same visit as a pacemaker check. The pacemaker check includes EKG monitoring, so unless the EKG is separate from that it shouldn’t be coded. If it is a separate EKG, then you can bill it with modifier 59, but you’ll also have to check the local coverage determination (LCD) medical policy to see whether there are specific diagnoses required. Documentation would need to be clear in the medical record that it is a separate EKG.

I got this from: http://panaceahealthsolutions.com/q...chives/69-cardiology-compliance-question.html.

You may be able to find something more concrete like an article addressing this specifically but NCCI is pretty concrete. Your example would allow you to bill for the EKG.

HTH