Wiki Office and EKG billing

[mankwan]

what will be the correct code to bill for office visit with ekg 10 leads? i have billed 99214 and 93000 to medicare and medicare has been denied EKG 93000.

 

[jhendrix08]

What dx code did you use with the EKG? We've never had trouble getting reimbursement for office visit and EKG; the CPT code you are using is correct. I'm wondering if the Dx code is the issue.

 

[BethB123]

WE USE 95005 AND 95010 FOR OFFICE EKGS FOR MEDICARE

 

[WaterJunkie]

what will be the correct code to bill for office visit with ekg 10 leads? i have billed 99214 and 93000 to medicare and medicare has been denied EKG 93000.

I've seen ECG's billed either 93005 & 93010 to do split billing or 93000 on a 1500 claim. One denial reason could be the number of ECG being billed. What denial are you getting?

 

[csperoni]

I assume the above poster means 93005 & 93010. However, if you own the equipment, perform the ECG and provide a report, 93000 is the correct code. I would think the problem is the diagnosis.

 

[eoroz2381]

If the patient is having their initial ECG and they have medicare, do you use the G0404 and G0405? Would the appropriate diagnosis code for the screening be Z13.6 screening for cardiovascular disorders? Also, We are getting the 93000 denied would we bill the 93005 and 93010 instead?

 

[twalls]

WE USE 95005 AND 95010 FOR OFFICE EKGS FOR MEDICARE

Can you tell me why you split bill these for Medicare? Don't they deny one as duplicate and pay the other? Why wouldn't you just bill 93000, if the provider is doing the work? THANK YOU!!!

 

[katemae84]

They must be a provider-based practice, so their practice would be considered a hospital outpatient department (POS 19 for off-campus hospital departments or POS 22 for on-campus hospital departments) rather an office, POS 11. The physician practices I work for are set up the same way. The claims don't deny as duplicate because you bill the professional services on a 1500 and the facility/technical components on a UB.

 

[twalls]

They must be a provider-based practice, so their practice would be considered a hospital outpatient department (POS 19 for off-campus hospital departments or POS 22 for on-campus hospital departments) rather an office, POS 11. The physician practices I work for are set up the same way. The claims don't deny as duplicate because you bill the professional services on a 1500 and the facility/technical components on a UB.

Thank you so much for your reply! That makes much more sense, I couldn't find any information on this and hopefully I can solve some of our issues!

Again many thanks!
Tammy