Jumpstart your ECG Medical Billing with Correct Coding

When a patient has an ECG, it is usually for diagnostic purposes and if you don’t do the medical billing correctly to show the medical necessity of the procedure performed, it can result in the claim being only partially paid or completely denied by the carrier.

The code range affected is:

*93000 (Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report) if the physician performed the ECG and the interpretation

*93005 (… tracing only, without interpretation and report) if the physician performs an ECG with tracing only

*93010 (… interpretation and report only) if the physician does not own the ECG equipment.

When you need to prove the medical necessity for the ECG exams, begin with a solid diagnosis for the reason for the procedure. Be detailed and explain why the procedure was necessary and any failed treatments that have led up to the necessity of the ECG.

Being specific in your medical billing is very important when getting this type of claim reimbursed. Get all the information you need from the physician up front and ask for clarification for anything that may need expanding upon. This practice will help more and more of your medical billing claims realize a full reimbursement for ECG services.

View all Articles by: Melissa Clark, CCS-P