EKG is usually done in continuous manner during a heart surgery, and
therefore it's considered an integral part of the main surgery and so
would not be paid separately. Physicians need to monitor patient's
heart's electrophysiologic behavior throughout the procedure.
Electrocardiograms are considered incidental to a stress test, a cardiac test which
includes an ECG as part of the test, and as part of initial hospital care. A 3 lead ECG is considered
incidental to a 12 lead ECG. Separate reimbursement is not provided for ECGs which are considered incidental.
An ECG is considered mutually exclusive to provider services for cardiac rehabilitation (93797). Separate
reimbursement is not provided for ECGs which are considered mutually exclusive.
To bill ECG/EKG (93000-93010 / 93040-93042), the specific request for the procedure should come from the doctor. Check the CPT guidelines before code 93000:
"Codes 93040-93042 are appropriate when an order for the test is triggered by an event, the rhythm strip is used to help diagnose the presence or absence of an arrhythmia, and a report is generated. There must be a specific order for an electrocardiogram or rhythm strip followed by a separate, signed, written, and retrievable report. It is not appropriate to use these codes for reviewing the telemetry monitor strips taken from a monitoring system. The need for an electrocardiogram or rhythm strip should be supported by documentation in the patient medical record."
Also, EKG machine/electrodes come under "routine supplies" when done in a hospital. Routine supplies are items used during the normal course of treatment, which are directly related to and/or integral to the performance of separately payable therapy, treatments, procedures, or services. These supplies are customarily used during the course of treatment and are normally found in the floor stock, which are generally
used by all patients in that specific area/or location. Reusable supplies and equipment may also be considered routine.
Routine supplies should not be separately billed to a patient or a payor. When charging for routine supplies, hospitals have an option to include the charge in the charge of procedure/service, the accommodation charge, the operating room charge, or the E&M visit, or capture it on the hospital Cost Report.
The CCI bundling policy shows that CABG code (33510) bundles EKG code 93000 with a modifier indicator 1, suggesting you cannot bill EKG separately.
Electrocardiograms are considered incidental to a stress test, a cardiac test which
includes an ECG as part of the test, and as part of initial hospital care. A 3 lead ECG is considered
incidental to a 12 lead ECG. Separate reimbursement is not provided for ECGs which are considered incidental.
An ECG is considered mutually exclusive to provider services for cardiac rehabilitation (93797). Separate
reimbursement is not provided for ECGs which are considered mutually exclusive.
To bill ECG/EKG (93000-93010 / 93040-93042), the specific request for the procedure should come from the doctor. Check the CPT guidelines before code 93000:
"Codes 93040-93042 are appropriate when an order for the test is triggered by an event, the rhythm strip is used to help diagnose the presence or absence of an arrhythmia, and a report is generated. There must be a specific order for an electrocardiogram or rhythm strip followed by a separate, signed, written, and retrievable report. It is not appropriate to use these codes for reviewing the telemetry monitor strips taken from a monitoring system. The need for an electrocardiogram or rhythm strip should be supported by documentation in the patient medical record."
Also, EKG machine/electrodes come under "routine supplies" when done in a hospital. Routine supplies are items used during the normal course of treatment, which are directly related to and/or integral to the performance of separately payable therapy, treatments, procedures, or services. These supplies are customarily used during the course of treatment and are normally found in the floor stock, which are generally
used by all patients in that specific area/or location. Reusable supplies and equipment may also be considered routine.
Routine supplies should not be separately billed to a patient or a payor. When charging for routine supplies, hospitals have an option to include the charge in the charge of procedure/service, the accommodation charge, the operating room charge, or the E&M visit, or capture it on the hospital Cost Report.
The CCI bundling policy shows that CABG code (33510) bundles EKG code 93000 with a modifier indicator 1, suggesting you cannot bill EKG separately.
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