Wiki EKG with Preventive Exam

[mmary1]

Hello! When an EKG is performed as part of a preventive exam, what DX code should be used? We have been using V81.2 as primary, with any pre-existing DX as secondary. Is this correct? We are getting denials as non-covered service. This holds true for labs (V72.62 and any pre-existing DX as secondary) and hemoccult (V76.41 and any pre-existing DX as secondary) done during the same visit. Would appreciate input! Thank you.

 

[nloguercio]

We have always billed out the EKG along with the V70.0. (For non-Medicare patients). Some private payors pay it, some don't. If the patient also has a cardiac pre-existing condition that our office manages such as HTN 401.9, we would code that instead. For the venipuncture if you are using 36415, we also use the V70.0. Most insurances will pay a routine veni with a preventative exam. The hemoccult we also use V76.41 and it usually gets paid although some companies consider it bundled so at that point we just adjust it off.