Tacoma - 93000 - 93010 - Hone Your Ecg Coding Skills With These 3 Key Pointers
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Grasping the effects of 93010 on new vs. Established patient status could bring a bonus of .
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Whether you call them Ecgs or Ekgs, there are chances you will see a lot of electrocardiograms in your practice. That means that even the smallest coding errors can add up quickly. Brush up on the 93000-93010 basics with this retell of the service, the code components, and the role Ecgs can play in selecting the right E/M code.
Rely on These Codes for allowable Ecg Reporting
There are three codes for disposition Ecg:
93000 - Electrocardiogram, disposition Ecg with at least 12 leads; with interpretation and report 93005 -... Tracing only, without interpretation and report 93010 -... Interpretation and article only
Christina Neighbors, Ma, Cpc, Ccc, Acs-Ca, fee capture reconciliation specialist and coder at St. Joseph Heart & Vascular center in Tacoma, Wash says, these codes describes the services which involves placing six leads on the patient's chest and further leads on each extremity. The procedure "picks up and traces the path of electrical action sent from the Sa [sinoatrial] node straight through the heart and puts it onto paper," Neighbors adds.
Cpt Assistant (April 2004) explains that the external skin electrodes can pick up electrical current because the heart's electrical action generates currents that spread to the skin.
Prevent Denials With This Modifier 26 Rule
Just say no to modifier 26 (Professional Component) with your Ecg code, says Kim Huey, Cpc, Ccs-P, Chcc, an independent coding consultant in Auburn, Ala. Likewise, you should not append modifier Tc (Technical component).
Reason: Codes 93000-93010 are already broken down into professional and technical components, Huey says:
93000: global (professional and technical components) 93005: tracing (technical component) 93010: interpretation and article (professional component).
In other words, if the cardiologist provides only the interpretation and article for an Ecg performed at a hospital, you should go for 93010, not 93000-26.
Helpful: If you ever need a reminder about either a code accepts modifiers 26 and Tc, the Medicare doctor fee agenda (Mpfs) can be of help. Agreeing to the Mpfs, 93000 has a Pctc (Pc, Tc) indicator of "4," meaning "global test only" code. Code 93005's Pctc indicator is "3," which indicates "technical component only" code. And 93010's indicator of "2" means the code is a "professional component only." You can search the Mpfs at http://www.cms.hhs.gov/pfslookup/.
Determine either 93010 Patients Are 'New'
Your cardiologist's role in an Ecg interpretation could dictate either you elect a new or established patient E/M code at the patient's next visit.
Rationale: "An interpretation of a diagnostic test, reading an x-ray or Ekg, etc., in the absence of an E/M aid or other face-to-face aid with the patient doesn't sway the designation of a new patient," states Medicare Claims Processing Manual, episode 12, Section 30.6.7 (www.cms.hhs.gov/Manuals/).
Betsy Nicoletti, Ms, Cpc, founder of healing convention Consulting in Springfield, Vt. Says, "You just need to be sure you understand the definition of a new patient." A new patient is person who hasn't received professional aid from that doctor (or other doctor of the same specialty in the same group) during the last three years.
Medicare's decision to no longer cover consult codes makes mastering new versus established even more vital. Your consult code selection didn't differ based on either a patient was new or established, but the codes you use to replace the consult might. For instance, consult codes 99241-99245 specify: "Office consultation for a new or established patient..." In comparison, office/outpatient E/M codes 99201-99205 are for new patients only and 99211-99215 are for established patients only.
Payoff: If documentation supports your coding a visit previously reported as a consult as a level-five E/M service, for instance, knowing the inequity in the middle of new and established has an impact on your pocket. The Medicare non-facility national rate for a level-five new patient visit (99205) pays more than a level-five
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